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OXFORD -^ V \ 







This study is an attempt to give some account of 
one who was, so far as is known, the first English- 
man who was Court physician to an English monarch, 
and of his chief work, the Rosa Anglica, as it is 
generally called, though the name which he himself 
gave it was the Rosa Medicinae. 

The materials for an essay ^ dealing with medical 
matters in England, or indeed in Europe during the 
fourteenth century, are but scanty as compared with 
the accounts of medicine, medical studies, and medical 
men which we possess belonging to the twelfth and 
thirteenth centuries, and the admirable Fitz Patrick 
Lectures of Dr. J. F. Payne and Dr. Norman Moore 
have already made English readers acquainted with 
the English medical men of that period. 

In the section dealino- with the g-eneral estimation 
in which medical men were held during mediaeval 
times I have had to consult works written so far 
back as the twelfth century, but with the exception 
of Guy de Chauliac, who was ahead of his times 
in surgery, the medical art progressed but little 
between 1150 and the date of Vesalius. Indeed, if 
we can believe Moliere, the physicians of his time 
were of much the same kidney as those so amusingly 
satirized by John of Salisbury in about the year 1 180. 

^ ' I was still possessed by the old-fashioned notion, that the 
word " essay " meant an attempt and nothing more.' — Augustus 
Jessop, preface to Studies by a Recluse. 

A 2 


Little is known of John of Gaddesden apart from 
his book. He was a member of Merton College, he 
was in holy orders, but whether a priest or not is 
uncertain. He was a prebendary of St. Paul's and 
a Master of Arts, as well as a Bachelor in Theology 
and a Doctor in Medicine. For his course at Oxford 
I have had to depend upon the statutes quoted in 
Anstey's Munimenta Academica and upon Hastings 
Rashdall's Universities of the Middle Ages. For the 
kind of learning which a well-educated * Clerk * 
possessed in the fourteenth century I have taken 
Chaucer's life and learning as exemplified in his 

That the Rosa was held in high estimation by 
some at least of John's contemporaries and im- 
mediate successors is shown by the fact that Chaucer 
mentions it as forming part of the library of his 
typical physician, and by the way in which it is 
praised by the editor of the first printed edition. 
In his own preface Gaddesden remarks, quoting from 
Galen : ' Quia tamen nullus liber est sine vituperio, 
ideo nee iste liber sine vituperio erit. Rogo tamen 
ut istum librum videntes non dente canino mordeant 
. . . quia quicquid hie dicetur erit vel authenticum 
vel longa experientia approbatum.' I would ask the 
same indulgence, because hardly any of the book is 
original, save the translations, but original works 
have been consulted, and I have been careful, in 
accordance with Dr. Routh's dictum, to verify my 
references as far as possible. 


Mr. A. L. Smith gave me some valuable references 
dealing with information about Grossetete and his 
medical learning, acquired apparently at Oxford. 

Mr. Falconer Madan has been unsparing of 
himself in answering the many questions with which 
I fear that I have troubled him ; and for advice as 
to occasional difficulties in translation I have to 
thank Mr. R. F. Cholmeley, Dr. P. H. Mackellar, and 
Mr. C. C. J. Webb, who was kind enough to help me 
in portions of the passage from John of Salisbury. 

To the officials in the British Museum Reading 
Room, especially to Sir G. Warner and his assis- 
tant in the Manuscripts Room, I owe much ; and 
I am indebted to Miss J. Lewis for having been 
good enough to draw up the list of MSS. con- 
taining medical pictures, and for inquiring of various 
librarians as to manuscripts of the Rosa, inquiries 
which they, too, were most courteous in answering. 

I wish also to express the gratitude which I owe to 
the experts of the Clarendon Press, for all the care 
and trouble which they have taken, in making many 
most helpful suggestions and for aiding me to fill gaps 
in my deficient Latinity. 

As these pages were being finally revised for 
press, the death of Dr. J. F. Payne occurred. Of the 
blank which his passing makes in the ranks of those 
who write on the history of medicine there is no need 
to speak. But as one who had the honour of his 
friendship, who is, as he was, a member of Magdalen 
College, and who strives to follow him, lotigo inter- 


vallo, in an essay on a bygone period of British 
medicine, I must here record that without his ever- 
ready aid, and his desire that I should attempt the 
task, this study would probably have never been 
written. In the identification of the various writers 
whom Gaddesden quotes, and in the account of their 
works, Dr. Payne's wide knowledge of mediaeval 
writers on medicine was invaluable, and he spared 
neither time nor trouble, even when the shadow of 
death was lengthening upon him, in giving me in- 
formation. No words of mine can express Payne's 
character better than these of Ennius in describing 
the friend of Servilius Geminus : 

Cui res audacter magnas parvasque jocumque 
Eloqueretur, cuncta simul malaque et bona dictu 
Evomeret, si qui vellet, tutoque locaret. 
Quocum multa volup ac gaudia clamque palamque ; 
Ingenium cui nulla malum sententia suadet 
Ut faceret facinus, levis aut malu', doctu', fidelis, 
Suavis homo, facundu', suo contentu', beatus, 
Scitu',secunda loquens in tempore, commodu',verbum 
Paucum, multa tenens antiqua sepulta, vetustas 
Quem fecit mores veteresque novosque tenentem 
Multorum veterum leges divumque hominumque ; 
Prudenter qui dicta loquive tacereve possit. 

If this study be found to be a foundation upon which 
some future investigator,better equipped than myself, 
may build a revised and possibly corrected account 
of our first English Court physician, I shall feel 
that, however inadequately, it has been written in 
the spirit in which Dr. Payne would himself have 
written it. 




John of Gaddesden : His Education , . 9 

The Rosa Anglica 22 


The Mediaeval Physician . . . -75 


Opportunities for the Study of Medicine 
IN Oxford in the Fourteenth Century 

AND previously II O 


A. The Latin Text of the Editor's 
Dedication of the 'Rosa' . . .127 

B. Regulations in the Kingdom of Sicily 
AS TO Unqualified Practice and Regular 
Practice . . . . . . -131 

C. Text of Decree of Boniface VIII 
concerning the Mutilation of Bodies . 134 

D. 'The Isagoge' . . . . .136 

E. Gaddesden's Authorities . . .166 



John of Gaddesden died in 1361, and was pro- 
bably born about 1280, so that his active hfe quite 
covers the first half of the fourteenth century. The 
period in question was one which, although of 
enormous importance in the political and social 
history of the land, was not distinguished by learn- 
ing to nearly the same extent as was the previous 
century. In that century, after the coming of the 
friars, Oxford had rivalled Paris as a centre of 
learning ; but theology, as might be expected, was 
the faculty which attracted the great intellects of 
the age, although Roger Bacon has left an imperish- 
able memory in his Opus Majus, which, to quote 
Whewell, is ' at once the Encyclopaedia and the 
Novum Orgamim of the thirteenth century '. No 
such monument of intellect as this lightens the 
fourteenth century, but we have evidence that the 
ordinary clerk who had received the usual education 
of the time was at all events well read. 

Moreover, during the reign of Edward III English 
began to be the national tongue to the exclusion of 
French, and the poetry of Chaucer, with the prose 


of Wycliff, brought what they had to say home to 
the hearts of the people in their common speech, so 
that any one who could read or hear Chaucer's 
works would obtain knowledge of a number of 

Chaucer, who may be taken as a typical well- 
educated fourteenth-century layman,^ be it remem- 
bered, was not of noble birth but the son of a vintner, 
i.e. a member of what is now called the upper middle 
class. Early in life, however, he seems to have been 
at court; he bore arms in the campaign of 1359, 
and was made prisoner. Later on he went to Italy 
on diplomatic missions in 1372, 1374, and 1378, and 
between 1374 and 1391 he was Comptroller of 
Customs, a member of the Commons in Parliament, 
and Clerk of the Royal Works. Thus he was 
brought into contact with all classes of society, and 
his training and habits of life were not moulded by 
books or cloistral studies but by contact with his 

His writings show that he had read or was 
acquainted with the works of a number of authors 
which seems large even in these days, and which may 
well be dalled enormous if we consider the difficulties 
in his day of obtaining books. His learning, as 
exhibited in his works, is that of a man who was an 
omnivorous reader, who had what may be called 

^ The word ' layman ', both here and below, is used to denote 
one who, though a ' clerk ', was not in full holy orders, nor a 
medical man. 


a good though not an accurate memory, that is to 
say, he did not always 'verify his references'. 
Probably, however, this was due in great part to the 
fact that, owing to the scarcity of books, verification 
was by no means easy, and many of his errors are 
due to similar errors in the writings of authors from 
whom he quoted. But he was acquainted with the 
English literature, such as it was, of his own time ; 
he knew Latin, French, and a certain amount of 
Italian, and it is obvious that he had also read or 
had some knowledge of a number of works now only 
known to literary specialists, besides the classics. 

In Professor T. R. Lounsbury's exhaustive essay 
on * The Learning of Chaucer ' ^ a list of close upon 
a hundred books or authors is given concerning 
which Chaucer shows more or less knowledgfe. 
These works contain most of the knowledge of the 
time, and they include what may be summarized 
under the term ' letters ', astronomy, astrology, chem- 
istry or alchemy, medicine and theology. 

Such, then, was the learning possessed by a well- 
educated layman of the fourteenth century. It was 
the learning of a ' clerk ' of the era, and did not show 
any out-of-the-way erudition such as that displayed 
by Robert Burton or Jeremy Taylor some three 
hundred years later ; neither need we inquire here 
whether or no Chaucer had been at either of the 
Universities. As, however, he is the type of the 

' Studies in Chaucer : his Life and writings (London : Osgood, 
Mcllvaine & Co., 1892). 


educated layman, we may here enter upon the 
question as to what was the amount of learning 
possessed by the educated medical man of the time. 

Gaddesden's course at Oxford 

John of Gaddesden held, among other degrees, 
that of Master of Arts, and figures as having been 
admitted as Prebendary or Canon of St. Paul's 
Cathedral before 1333 (Papal Letters, Rolls Series). 

According to Anthony a Wood he was a Doctor in 
Physick and flourished at Merton College in 1320. 
Six years' study was required before a M.A. could 
gain a licence and incept in Medicine as D.M., so 
that at the latest he must have become a Master in 
1 314. But most probably it was earlier than this, 
for he was born about 1 280, and scholars in mediaeval 
days entered at the University very young, e.g. at 
Merton they were often only thirteen or fourteen 
years old, so that it may be supposed that John of 
Gaddesden would enter about 1294. The course in 
Arts was as follows : — 

A child whose parents determined that he should 
complete the Oxford course had first of all to be 
instructed in grammar, and there were various 
grammar schools in the city all connected with the 
University, the most famous of which (although its 
palmy days were at a somewhat later date — namely, 
1450 — than when Gaddesden may be presumed to 
have begun his course) was the school of the Angus- 


^.13 note 2, for 424 read 438. This note refers to the end of the 
third paragraph, not to the last paragj-aph, on p. 1 3 
p. 23 /. \o from foot, for 7tmo read 7mo 
p. 68 note, for Anselm read Anselm ? 
p. 74 /. \Zifor Liege r^ar^ Liege 
p. 180 /. 8, for Methau- read Metheo- 

Cholmeley : John of Gaddesden Jime, 191 2 

To face p. 12 



tinians, a relic of which survived until some fifty 
years ago in the phrase ' doing Austins '. 

Merton, however, possessed a grammar master of 
its own whose duty was to teach the parvuli, and 
these children lived in Holywell and later close to 
the college in Nun Hall. 

The scholars were taught Latin, to compose verse, 
and to compose essays {literas), which latter were to 
be written 'verbis decentibus non ampullosis aut 

sesquipedalibus et quantum possint sententia 

refertis '. Of these verses and letters they had to 
make a fair copy on parchment, learn them by heart 
{corde tenus), and repeat them to their master. They 
were to construe both in English and French, the 
latter, ' ne ilia lingua Gallica penitus sit omissa.' ^ 

After being well grounded in grammar, the scholar 
next began his real University course, when he had 
to attend lectures given in the schools by a Master 
in the faculty in which he sought to graduate. These 
lectures consisted entirely of oral instruction, and 
the scholars were after a time obliged to repeat 
what they had learned. A relic of this custom 
existed thirty years ago at Eton in the form of 
' saying lessons '. 

Four years' study had to be spent before a scholar 
could supplicate for the Chancellor's licence, ' ad 
lecturam alicujus libri Facultatis Artium,' ^ and during 

' Munitnenta Academica, p. 437 et seq. 

' Mutiim. Acad., p. 424. Anstey, in his introduction to 
Munitnenta Academica, says : ' The statute in which this pre- 


these four years had to present himself for Respon- 
sions, which were a kind of exercise preHminary to 
the great disputations at Determination. 

It is as regards Responsions that we meet with 
the term parvisus. Thus the bachelors before 
being admitted to Determination had to swear that 
they had disputed ' Parvisum . . . frequentantes ' ^ 
and the testamur given until 1893 for the modern 
Responsions testified that the candidate * quae- 
stionibus Magistrorum Scholarum in parviso pro 
formi respondit'. 

The next step in the Arts course was Determina- 

caution is taken is unfortunately of the number of those which 
are of utterly uncertain date so far as can be ascertained from the 
MSS., it is, however, .... probably of the thirteenth century.' 
French, or rather Anglo-Norman, did not finally give way to 
English until the latter half of the fourteenth century, and for 
some time previously ' French of Paris ' had ousted that of 
'Stratford atte Bowe'. In 1362 English was ordered to be the 
language in courts of law, for French was too unknown. Possibly, 
then, the above quoted statute is later than Anstey puts it. 

In MS. Sloane 1464, a French manuscript of the Book of Sir 
John Mandeville written about the beginning of the fifteenth 
century, is the following passage : ' Et sachetz que jeo usse mis 
ceste liverette en Latyn pur plus briefment deviser, mes pur ceo 
que plusours entendent mieultz Romanz que Latin, jeo I'ai mys 
en Romanz pur ceo que I'entendent.' The Cotton MS. Tit. C. xvi, 
written in English about the year 1400, speaks as follows, the 
passage being an interpolation of the scribe : ' I have put this 
boke out of Latyn into Frensch, and translated it agayn out of 
Frensch into Englyssche that every man of my nation may undir- 
stonde it.' These two passages, although not written by Mande- 
ville, seem to show that French was well understood, although 
beginning to be a ' foreign ' tongue in England in 1400. 

' In 1408. 


tion, which ceremony or exercise was the practical 
takine of the Bachelor's decrree. Determinations 
were held in the Schools by order of Congregation, 
' placet venerabili Congregation! Regentium et non 
Regentium ne liceat eis (the determining bachelors) 
extra scholas triginta duas infra "vicum scholarum" 
situatas determinare acta sua '} 

Determinations lasted seven days, seven entire 
days, that is, for the opening and closing days were 
not considered as entire days, ' diebus primi introitus 
et extremi exitus minime computatis'. The deter- 
miners disputed every day from 9 till 1 2 and from 
I till 5, so that the exercise was a severe test of 
ability to argue and to defend propositions. A 
determiner had to dispute Logic every day except 
Friday, when Grammar was the subject ; and the 
first and last days ' in quibus disputet questiones '. 

The statutes do not seem to consider the question 
of a determiner failing at Determination, but before 
beino- admitted to determine the Bachelor had to 
obtain a certificate of fitness from certain Masters 
or Bachelors, and then had to appear before four 
Regent Masters who had been appointed by Con- 
gregation. Here he had to make oath that he had 
complied with the necessary forms and -had ' heard ' 
certain books, such as those of the old logic, twice, 
and the logical works of Boethius except Book IV, 
Top2co7'um, once. In the new logic the books 
Priorjim, Topicorum, and Elenchoriim had to have 
^ Munini. Acadefn., p. 240. 


been heard twice, but once was considered sufficient 
for the liber Posterioriim. 

The candidate also had to make oath that he had 
' heard ' certain books of Priscian and Donatus or 
Natural Philosophy, by which was meant the Pkysica, 
the de Anima, the de Generatione et Corruptione, 
and the Historia Animalium, He also had to swear 
that he had been through Responsions, i.e. 'publice 
de sophismatis per annum integre debet respon- 
disse,' or in lieu of this that he had heard the liber 
Posteriorum twice instead of once. 

The Bachelor being admitted to Determination 
then proceeded as above described, and having 
survived the ordeal of nine days' disputing found 
himself barely at the threshold of the Arts course. 
After determining as a Bachelor the scholar had to 
study for three or possibly four more years, but the 
statute is very obscure.^ He could incept without 
determining, but then he had to have studied for 
eight years (?) in all. 

The studies after determination as a Bachelor and 
before inception as a Master were chiefly Logic 
and Natural Philosophy. The authors to be studied 
are laid down in various statutes, and differ from 
time to time, but in 1 340 ^ two logical books were 
prescribed at the least, ' unum de veteri logica, et 
alterum de nova ' ; or both might be read from the 
new logic together with one book on natural philo- 

^ Munim. Acadeni., pp. 414, 416. 
^ Munim. Academ., p. 142. 


sophy, i.e. Aristotle's works, namely, four books, 
Coeli et Mttndi\ or three books, de Anima; or four 
books, Meteorortim ; or two books, de Generatione et 
Corruptione ; or the book, de Sensu et Sensaio ; to- 
gether with the treatise, de Memoria et Remmiscentia 
and that de Somno et Vigilia ; or the de Motu 
Animalium; together with two books, de Mimitis 

Shortly, it may be said that the full Arts course 
included the seven Arts, namely. Grammar, Rhetoric, 
Logic, Arithmetic, Music, Geometry, Astronomy ; 
and the three Philosophies, namely, Natural, Moral, 
and Metaphysical, although these do not appear to 
have been laid down by statute before 1431.^ 

So much for the studies, but before taking his 
degree as a Master the candidate had to get a Master 
to present him to the Chancellor and the Proctors, 
which Master had to take oath that he believed the 
candidate ' aptum et idoneum moribus et scientia ad 
eum gradum ad quem praesentatur '.^ More than 
this, the Proctors, by the authority of the Chancellor, 
were to summon eighteen Regent Masters ' per quos 
Veritas melius inquiri poterit ' ; and of these eighteen, 
nine had to depose that of their certain knowledge, 
and five that of their belief, their candidate was 
a proper person to receive the degree. The present- 
ing Master was not to be one of the eighteen.^ 

These formalities being complied with, the candi- 

^ Munim. Acadeni., p. 285. * Ibid., p. 378. 

^ Ibid., p. 424. 
ijoa B 


date appeared before the Chancellor, with whom 
the Proctors sat as assessors, and on takuig the oath 
of obedience to the University and that he would 
' incept ' within a year, received his degree.^ 

'Inception' apparently meant that the newly 
appointed Master began a course of official lectures, 
and he had to continue these lectures during the 
year of his inception and the year following,^ and 
if he did not do so, ' denuncietur nee inter Magistros 
et Scholares Oxonienses recipiatur.' 

The Arts course, then, was obviously a severe 
training in intellectual studies ; it was mainly made 
up of dialectic,^ but to have passed through it with 
success meant that a man could hold his own in or- 
dinary life, that he had an understanding, so far as 
was then known, of physical science, and that he had 
mingled with his fellow men from various districts of 
his native land and with foreigners for some seven 
or eight years. 

But of literary or artistic training as we now 
understand it there was virtually none except one 
term's study of music ' per terminum anni, videlicet 

^ Mtmim. Academ., p. 383. 

^ Ibid., p, 419. 

^ The ars logica or ars dialectica was, however, it must be 
remembered, considered as a necessary part of a medical man's 
training. See the decree of Frederick II quoted below, and the 
requirements for a medical man laid down by Isidore of Seville. 
Scholastic disputations were not always, it must be remembered, 
of the 'Utrum Chimaera in vacuo bombinans possit comedere 
secundas intentiones ' type. 


Boethii V and probably music was but little under- 
stood except by those trained in a religious house. 
Greek, of course, was practically unknown. 

Enough, however, has been said to show that 
a Master of Arts possessed a very good mental 
training, and if, as many graduates in arts did, he 
proceeded to study in one of the higher faculties, it 
is obvious that he would do so much better equipped 
than many a student nowadays who begins the study 
of medicine or even law. 

John of Gaddesden was not only a Master of Arts 
but also a Doctor in Medicinis^ and a Bachelor in 
Theology, and he presumably took his medical 
degree before that in theology, for the course for 
the latter was very long and the Rosa Anglica was 
written about 13 14. 

Supposing him to have been born in 1280, he 
would scarcely enter at the University before the 
age of fourteen years, i.e. in 1294. He would then 
spend at least two years in the study of ' grammar ', 
and would then in 1296 begin his studies for the 
Baccalaureate. This would bring him to the year 
1 300, while in three more years he would be a Master. 
Thus he would begin to study medicine in 1303. 

^ Munim. Academ., p. 286. 

^ A. Wood, Antiq. Oxon., Lib. ii, 'Johannes de Gatisden de 
quo sic Vetus Sociorum hujus Collegii (Merton) Catalogus 
Doctor in Medicinis qui fecit Rosarium Medicinae. Claruit 1320.' 

B 2 


Preliminary Studies for Inception in Medicine 

The statutes concerning degrees in medicine and 
the studies are by no means clear. For inception 
in Medicine, inceptio ad lectiiram^ which apparently- 
included the taking of the B.M. degree/ the candi- 
date had to have ' read ' one book of the Tegni, i. e. 
T€x»'J7, of Galen, or one book of the Aphorisms of 
Hippocrates, /rfi* niajori parte. These were to serve 
as far as ' theory went '. As regarded practical medi- 
cine, the candidate must have read one book of the 
Regimentum Acutornmoi Hippocrates, or the Liber 
Febriuin of Isaac, or the Antidotarium of Nicolaus 
(Praepositus, of Salerno). A candidate must also 
have responded to the Masters Regent in the faculty 
for two years. 

Before being allowed to practise in Oxford he 
had, if he had previously graduated in Arts, to spend 
four years in the study of medicine ; and to pass an 
examination conducted by the Masters (Doctors) 
Regent in that faculty. If he were not a graduate 
in Arts, eight years' study were required. 

For licence, candidates had to have heard Medi- 
cinalia for six years, to have read cursorie one 
medical book de pradica and another de theorica^ and 
to have responded and opposed in all the medical 
schools for two years. 

The Statutes apparently mean that a graduate 
had to spend six years' study in all and a non-graduate 

^ Munim. Academ., p. 406, n. 2 : ' prius incipitur a Medicina et 
gradu bachilariatus in eadem.' 


eight years. Certain exercises known as Vesperiae 
had also to be performed. When all the terms of 
study had been duly kept and all the exercises per- 
formed, the candidate was admitted to the Master's 
(Doctor's) degree after the same form as that ap- 
pointed in the Faculty of Arts. 

Thus it seems that the fourteenth-century English 
physician could enter upon practice without any 
other knowledo^e than that derived from books. 

Matters were very different at a somewhat earlier 
date in some parts of the continent. In the kingdom 
of Sicily, for instance, one of the glories of which 
was the great school of Salerno, strict injunctions 
were laid down from time to time by the Emperor 
Frederick and others to insure, so far as might be, that 
medical men should be soundly educated. More- 
over, unqualified practice was strictly forbidden.^ A 
decree to which the date 1241 has been assigned, - 
provides, it will be seen, not only for a thorough 
education, including human anatomy for a surgeon, 
but also for a post-graduate course.^ 

^ Appendix B, section i. 

"^ Huillaid-Breholles, Hist. Diplotn. Fred., vol. iv. pt. i, p. 235. 

* Appendix B, section 2. 


The British Museum possesses four printed 
editions of the Rosa Anglica. The first was printed 
at Pavia in 1492, and is a foHo printed in double 
cokimns, black-letter with contractions. The second 
was printed at Venice in 1502.^ This is also black- 
letter, with contractions and in double columns. The 
printing is clear and beautiful, and superior to that 
of 1492. Another edition was printed in 151 7. 
Finally, an emended and rearranged edition was 
printed at Augsburg in 1595. The editor was 
Dr. Philipp Schopf, who altered John's Latinity 
here and there and also the arrangement of the 
subjects, which it must be said was somewhat con-' 
fused in the original editions. But he to a great 
extent destroyed the qualntness of the work by 
leaving out the preface and many of Gaddesden 's 
extremely curious derivations, although he kept 
some of them. 

In his preface, which will be found below, John 
of Gaddesden says : ' Haec omnia ego Joannes 
de Gadesden ymo anno lecturae meae compilavi.' 
This gives us more or less an actual date for the 

^ Not 15 16. as is often stated. 


book, althouf^h the dates are mostly provisional, 
viz. : — 

I 280. Birth of Gaddesden. 

1294. Entered Oxford for grammar. 

1296. Began studies for B.A. 

1300. Graduated as B.A. 

1303. Incepted as M.A., and began to study- 

1307. Graduated B.M. ' Inceptio ad Lecturam.' 

1309. Graduated D.M. ' Inceptio ad Licentiam.' 

1 3 14. Wrote Rosa Anglica, i.e., in the seventh 
year of his 'lecture', which began in 1307. 

The Preface to the Rosa Anglica 

Sicut dicit Galienus primo de ingenio sanitatis : 
non visites curias et aulas principum : sicut nee ego 
feci quousque sciverim libros; quia dicit Galienus 7mo 
de ingenio in prohemio non est possibile per aliquod 
fieri proximius deo quam per scientiam. Ideo humili- 
bus optavi facere istum librum. Quia cum nullus liber 
est sine vituperio ; sicut dicit Galienus 2ndo de arise ; 
ideo nee iste sine vituperio erit. Rogo tamen ut 
istum librum videntes non dente canino mordeant 
sed humilitate pertractent, quia quicquid hie dicetur 
erit vel authenticum, vel longa experientia approba- 
tum : quae haec omnia ego Joannes de Gaddesden 
7tmo anno lecturae meae compilavi. Circa quem 
librum talem volo observare processum quod primo 
volo nomen investigare cujuslibet morbi ; 2ndo 
diffinitionem ; 3to occasionem ejus et causam, juxta 
illud Isaac 4to febrium et de icteritia : ' Omne quod 
volumus investigare tribus modis intelligimus, aut 
suo nomine quod est ad placitum, aut diffinitione 
ejus natura (m> ostendente, aut actione ejus effectum 
demonstrante, et ibi actio idem est quod occasio vel 
causa.' 4to dicam signa generalia et specialia, quae 


accidentia infirmo sunt signa medico, ut dicit Joanitius 
c<apitulo> de signis officialium membrorum. 5to 
prognosticationem, 6to curam et ibi sequendo Mesue, 
dicam quae sunt facienda in cura cujuscunque morbi 
periculosi et curabilis. Ante tamen capitulo primo 
ista fiant volo nomen isti libro imponere, vocando 
ipsum Rosam Medicinae propter quinque additamenta 
quae sunt in rosa, quasi quinque digiti tenentes rosam, 
de quibus scribitur. 

Tres sunt barbati sine barba sunt duo nati. 
i. e. tres articuli vel partes circumdantes rosam sunt 
cum pilositate, duae sunt sine, et ideo erunt hie 
quinque libri. Primi tres erunt barbati barba longa, 
quia ad multa se extendent, quia erunt de morbis 
communibus, et quot modis dicatur morbus communis 
vel vilis vide in prohemio secundi. Duo sequentes 
erunt de morbis particularibus cum declaratione 
aliquorum omissorum in precedentibus, quasi sine 
barba. Et sicut rosa excellit omnes flores, ita iste 
liber excellit omnes practicas medicinae, quia erit 
pro pauperibus divitibus chirurgicis et medicis, de 
quo non opus multum recurrere ad alios libros, quia 
hie videlicet sat de morbis curabilibus in speciali 
videbitur et in generali. 

The conclusion of the preface is simply a list of 
headings of chapters in the first book. 

Translation of above Preface 

As Galen says in the first book of his treatise de 
Ingenio Sanilatis, ' Do not frequent courts and 
princes' houses : ' as indeed I never did until I had 
acquired a knowledge of books,— for Galen in the 
introduction to the seventh book of the de Ingenio 
says that it is impossible to become nearer to ^God 
by any other way than by the way of knowledae 


— therefore I have wished to write this book for the 
humble to read. Because since no book is without 
reproach, as Galen says in the second book of his de 
Crise, so neither will this one be. But all the same, 
I implore those who see it not to gnaw it with an 
envious tooth, but to read it through humbly, for 
nothing is set down here but what has been proved 
by personal experience either of myself or others, and 
I, John of Gaddesden, have compiled the whole in 
the seventh year of my 'lecture'. And in regard to the 
whole book I intend to observe the following order 
of arrangement : first of all I try to investigate the 
name of any disease, secondly its definition, thirdly 
its incidence and cause. As Isaac says in the fourth 
book of his Fevers and in his section on Jaundice : 
' We can discuss everything which we wish to 
investigate in a triple fashion : we can consider either 
its name, which is a matter of arbitrary convention ; 
or its definition, which indicates its nature ; or its 
action, which indicates its effect, and in this use ' actio ' 
is equivalent to incidence or cause.' In the fourth 
place I give an account of the signs, both general and 
special, and what happenings to the patient are signs 
to the medical man, in accordance with Joanitius in 
his treatise on the signs of the official members.^ 
In the fifth place I give the prognosis and in the 
sixth place the cure, and here following Mesue I 
give all things which are to be done for the cure 
of any dangerous disease which is capable of cure. 

But before these matters are treated in the first 
chapter, I wish to give a name to the book, namely, 
the Rosa Mediciiiae, and I have so called it on account 
of five appendages which belong to the rose, as it were 
five fingers holding it, concerning which it is written : 

• Three are bearded and two are not. 
^ Vide Appendix on the Isagoge. 


That is to say, three of the parts surrounding the 
rose are hairy and two are smooth, and the same is 
the case with the five parts of my book. The first 
three are bearded with a long beard, for they treat 
of many things and about general diseases, and for 
a discussion of what constitutes a general or common 
disease look in the introduction to the second book. 
The two following books treat of particular diseases, 
together with some matters omitted in the preceding 
books, and they are as without a beard (shorter). 

And as the rose overtops all flowers, so this book 
overtops all treatises on the practice of medicine, and 
it is written for both poor and rich surgeons and 
physicians, so that there shall be no need for them 
to be always running to consult other books, for here 
they will find plenty about all curable disease both 
from the special and the general point of view. 

The copy of the 1492 edition, which is the one I 
have used, is that belonging to the Library of the 
Royal Society of Medicine, and originally belonged 
to Dr. Mead. It is dedicated by the editor, Nicolaus 
Scyllatius Siculus, in a delightfully fulsome preface, 
to Ambrosius Varisius Rosatus Ducalis Physicus ac 
Consiliarius. The duke was Ludovico Maria Sforza. 
The full Latin text will be found in the appendix. 
The editor begins by saying that, in his opinion, the 
gods were originally men who had been elevated to 
this position on account of benefits which they had 
conferred on their fellow men. If Ambrose has not 
quite attained to this height as yet, it is well known 
that every one respects and honours him. He is 
accomplished in the law, in diplomacy, in physic, and 
in letters, and under his patronage the University of 


Pavia has attained to an eminence never before 
known. The editor therefore begs to dedicate the 
Rosa as ' a learned and eminently instructive little 
present' to Ambrosius. He continues : 

' Joannes Antonius Birreta (the printer) told me a 
short time ago that he had obtained a Rosarium in 
Medicina, an uncommon and scarce work, one of the 
greatest use to young men, and one, too, specially 
sought after by the old and experienced. He oftered 
me every opportunity of reading it, and therein I 
discovered many recondite matters which these, after 
some other modern writers, Nicolaus Florentinus, a 
man skilled in every branch of medicine, had picked 
out and embodied in his mighty volumes, just as a 
bee picks out the more useful parts from roses. Now, 
since the said Birreta, who is a model of old time 
worth, as he is modest in demanding anything, asked 
me to correct the book (though it was not for him 
to request, to whom I owe my life), we have performed 
the task at the expense of much trouble and research. 
We have to the best of our ability restored that 
which was maimed by the mouldiness of long lying by 
and corrupted by the carelessness of scribes, the places 
where old writers were wrongly quoted have been 
diligently collated, and so far as possible the book has 
been restored to its original shape. So that. the real 
old Rosarius, like a prodigal reco^^nized on his return 
from long and difficult wanderings, is restored at last 
in his best robe to his friends. (" Ut qui Rosarius 
olim fuisset, nunc agnitus veluti ex horrida et 
longa peregrinatione, domum tandem excultus ad 
suos rediret.") 

You, therefore, Ambrose Rosatus, he recognizes as 
his patron and lord, and you who frequent kings' 
houses and the palaces of princes he has gained as 


his defender. When you read him, you will not 
mind reading him again, so varied and of such tried 
worth, so many and so quick to cure, are the remedies 
which he sets forth. Whence it comes, and that 
rightly, that as it has been for a long time received 
amongst us that the rose is the most beautiful of 
flowers, so this book easily overtops the labours and 
treatises of all the more recent authors who have 
written on the same subject.' 

Scyllatius then goes off into a digression upon the 
beauty of the rose, and quotes a story from Libanius 
of how Venus, wishing to make herself beautiful for 
the judgement of Paris, supplied the place of the 
cestus, which the jealousy of Juno and Minerva would 
not allow her to wear, with roses. He concludes his 
dedication with a high compliment to Birreta and his 
partner Franciscus Girardengus for the care with 
which they always did their work. 

Unfortunately the opinion of Ambrose upon the 
Rosa has not come down to us, but it is evident that 
Scyllatius thought most highly of the work. 

Nothing seems to be known of Ambrose, but 
Dr. Payne kindly sent me the following note : 

' Ambrosius Varisius Rosatus. He does not seem 
to be mentioned in any biographical dictionary. 
Apparently he was a medical big-wig of the day, 
being Physician to the Doge of Venice, &c., and was 
a greater man than the editor Scyllatius. This latter 
wrote a little tract on syphilis, and also dedicated it 
to Ambrosius Rosatus (Pavia, 1496, 4to) according 
to Hirsch, Bw^. Lex. In a copy of the Articella 
published at Pavia, 15 10, there is a dedication to 
Ambrosius Rosatus by a certain Rusticus Placentinus. 


He says, " excellentissimo philosopho, consummatis- 
simo medico, magnihco viro domino magistro Ambro- 
sio Varisio Rosato, Rusticus Placentinus theorice 
medicine in Ticinensi gymnasio lector ordinarius. 
S. P. D." 

I think it shows that Ambrosius was probably an 
influential and wealthy man who might reward the 
dedication with a handsome present' 

The Rosa commences with a treatise in two sections 
on Fevers after the Galenic system, and then goes 
on to consider the ' particular diseases '. A section 
on surgery follows, and the book ends with an 

The work is largely a compilation from the Greek, 
Arabian, and Jewish physicians, together with the 
works of his immediate predecessors such as Gilber- 
tus Anglicus and Bernard of Gordon, but it also 
contains many personal observations which show 
that Gaddesden must have had a large practice. 


As an example of Gaddesden's style the section 
on Hydrops may be taken as characteristic. The 
disease (for naturally he considers it a disease) is 
very fully treated, and in the description we find 
passages which show both his knowledge and his 
limitations. It beeins thus ^ : 

' Idropisis is a watery disease inflating the body. 
The name "Idropisis" is derived from "idros", which 
is water, and ' isis ', which is inflation, that is to say 

^ Rosa Afigiica, Pavia, ed. 1492, f. 36. 


a watery inflation. And so Haly in the third part 
of the commentary on the Tegni, 192, says, " Subtile 
and watery juices bring about watery sicknesses such 
as hydrops." And it is thus defined : Hydrops is 
a material sickness of which the cause is a cold 
matter, overflowing and entering into the limbs, and 
thence arise either all its manifestations, or empty 
spaces of those organs in which is carried on the 
government of the food and the humour. (" Idro- 
pisis est egritudo materialis, cujus causa est materia 
frigida, exuberans, ingrediens membra : et crescunt 
per eam aut manifesta omnia, aut loca vacua partium 
in quibus sunt {sic) regimen nutrimenti et humoris.") 
So says Avicenna, Fen. 14, tract. 4, cap. de idrope. 
Again he says, Hydrops is an error of the combining 
energy {virttiHs tinitivae) in the whole of the body, 
following on a change of the digestive energy in the 
liver. So much we may gather from Avicenna, 
Can. I, fen. i, doctrina 6, cap. 2, and also in book 6 
de nahu^alibtis virtutibus. For there he says that 
when the nutriment is combined {imitur) in a limb, 
there it remains and swells it up. And Avicenna 
also says that when the nutriment does not cleave 
(to the members) thence arise hydrops. For the 
nutriment undergoes a triple dissolution : ^ in the 
first it is digested and dispersed throughout the 
members ; secondly, it is combined ; and thirdly, it 
is assimilated. Others say that in the first place it 
is distributed ; in the second it cleaves {adhaeret) 

^ Macrobius, circa 380 a. D.,in his Saturnalia, Bk. VII, through 
the mouth of Disarius, one of his characters, says that the food 
undergoes four digestions : the first in the stomach ; the second 
in the hver ; the third in the veins and arteries, where the watery 
part is separated and goes into the bladder, while the pure fatten- 
ing blood is distributed over the body ; and the fourth is that 
process by which every member of the body takes up that which 
is necessary for it. 


and in the third becomes fit for nourishment and is 
assimilated. When it is not distributed there arises 
" sinthesis " or widespread emaciation ; when it does 
not combine, or cleave to the members, there arises 
hydrops ; when it is not assimilated there arise 
leprosy {lepra) or morphea, as will be shown further 

A few lines further down he repeats his former 
definition, ' Idrops est error virtutis unitivae in toto 
corpore, sequens mutationem virtutis digestivae in 
epate ' ; but he adds, ' non est idropisis nisi epar 
patiatur.' And so Galen, in the third part and fourth 
chapter of his work on interior diseases, says, ' Epar 
idropici non est epar.' 

He then goes on to quote from Galen to show the 
intimate sympathy which exists between the liver 
and the other viscera, pointing out its anatomical 
continuity with the stomach, the intestines, the 
kidney, and many other parts of the body ' per venas 
magnas ', while it is tied to the heart, ' cordi coUigatur 
per arterias.' 

There are three kinds of Hydrops : — hyposarca, 
ascites, and tympanites. Hyposarca is that form in 
which there is ' materia phlegmatica penetrans cum 
sanguine in membra '. It was so called from v-no and 
o-a/o^, ' quasi sub carne stans aqua et ideo in ista specie 
hydropisis est inflatio universalis '. The complaint 
was also called anasarca. 

Ascites is that species of hydrops in which the 
watery material is effused ' in spatium ventris in- 
ferioris' and the effusion lies between Mirac and 


Siphac.^ These words Gaddesden explains as 
follows : 

* Est autem Mirac pellicula gibbosa, sive pinguis 
supra totum ventrem, propinquior cuti exterius. Sed 
Siphac est pellicula adhaerens intestinis in medio, et 
involvens ea, et supportans inferius dividens ea a 
membris generativis ut videbitur infra ; et haec 
aquositas intrat per poros illius Mirac rarefacti vel 
extensi a multitudine materiae indigestae in hepate 
quam non potest expellere et ideo ibi manet. . . 

Tympanites, the third kind of hydrops, is, says 
Gaddesden, wrongly called hydrops, for it is not 
humidity but ventosity. So far, then, if for ' the 
quantity of undigested material in the liver' we read 
' portal obstruction ', the pathology of the fourteenth 
century is not far wrong, but when Gaddesden comes 
to speak of the general causes of hydrops the same 
cannot be said. He quotes Galen to show that 
hydrops is a ' nocumentum virtutis generativae san- 
guinis, quando deficit ab illo opere et deest comple- 
mentum ejus '. 

Another frequent cause is cold, and another is 
retention of the wonted evacuations. Here he quotes 
Hippocrates concerning the danger of curing old 
haemorrhoids, for ' si non una relinquatur periculum 
est hydropem fieri '. 

With regard to the special causes of hydrops he 
lays special stress upon all foods which cause ' Malam 
complexionem hepatis calidam.' These are such 

^ Mirac is the abdominal wall, minus the peritoneum. Siphac 
is the peritoneum, or sometimes, possibly, the great omentum. 


things as foods salted or fried, spiced, overcooked ? 
{assata), and highly flavoured things such as garlic, 
chives, and leeks. This remark shows a certain 
amount of observation, for although such articles of 
food would probably have no direct causative influence 
upon cirrhosis, yet they are the very things forbid- 
den to lithaemic patients, and by causing indigestion 
might not improbably be a factor in doing harm to 
those of a gouty tendency or those who suffer from 
arterial sclerosis. 

It Is when we come to the clinical picture of 
a case of ascites with obstructive jaundice that Gad- 
desden shines, for It Is wonderfully vivid : 

' Signa ascitis futurl sunt : malus color faciei 
tendens ad citrinitatem, urina tincta frequenter, 
neque tamen patlentes de morbo conqueruntur : 
citrinitas oculorum frequens, et nocumentum lateris 
dextri sub costis quando patiens movetur, vel statim 
super cibum equitat ; post coitum, aut tussim. 

SIgna actualis ascitis sunt : inflatio pedum et 
membrorum Inferlorum : et umbilicus eminet extra, 
et superiora fiunt gracilia ut brachia, coUum, pectus : 
pulsus est parvus et frequens, urina tincta, spissa, 
in parva quantltate micta et frequenter, cum spuma 
crocea et bicolor : allquando ocull inflantur propter 
fumos ascendentes ab hepate : adest anhelltus dlf- 
ficultas, tussis sicca, sitis fere Inextinguibills, appetitus 
cibi diminutio, propter Intensum appetitum potus, et 
si venter agltetur, sonat velut uter semiplenus aqua.' 

The clinical picture Is complete, and worthy to be 
compared with those drawn by Watson or Trousseau, 
though naturally when Gaddesden ventured on patho- 

1302 C 



logy he failed. His remark that * aliquando oculi 
inflantur propter fumos ascendentes ab hepate ' is a 
case in point, but in everything that he could observe 
he is singularly accurate. 

Gaddesden paid great attention to treatment, and 
was evidently fully ready to meet the universal 
demands of patients, that a medical man should ' do 
something for them'. His prescriptions are innu- 
merable; as Freind says, ' He seems to have made 
a collection of all the receipts he had ever met with 
or heard of : and I believe this book can afford us 
the best history of what Medicines were in use, not 
only among the Physicians of that time, but among 
the common people of Ejtgland, both in the Empiri- 
cal and Superstitious way.' The cure of hydrops is 
dealt with both from the general and the special 
point of view. 

The general cure he deals with as follows (f. 39 
verso, first col.) : 

' The cure of hydrops is of two kinds, common 
and proper. The proper is by means of various 
appropriate medicines and by local measures. The 
common, as says Avicenna, is by extraction of the 
watery humidity and its drying up, and this extrac- 
tion may be carried out in four ways, as Constantine 
lays down in the seventh book of his Practice. The 
first method is by diuretic medicines which provoke 
a flow of urine such as spica (? nardi),^ cassia and 
the like. The second method is to purge out the 

' Where plants are not well known by their Latin names I 
have translated them according to the names given in Henslow's 
Medical Works of the Fourteenth Century (Chapman & Hall, 1899) 


yellow fluid by means of sweating and discharge from 
the bowels. For this latter effect use purging drugs 
such as succus ireos (Pmugwort) and succus laureolae 
(spurge laurel). Emetics and clysters can also be 
used. Sweating can be brought about by sulphur 
bath or sea baths, or by suffumigations with water 
in which have been boiled such roots or herbs as 
pellitory or levisticus (ligusticum officinale), together 
with bran ; or with inunctions of hot oil, with laurel 
bark or a hot ointment such as arogon, agrippa, or 
martiaton. The third method is for the patient to 
drink his own urine. This remedy is good not only 
in hydrops, but also in jaundice and in the splenetic 
affection. The whey of goat's or cow's milk also 
purges. The fourth method is by means of an in- 
cision three fingers' breadth below the umbilicus, and 
a deep perforation made therein, or by a perforation 
made in the bursa testiculorum, or by intercutaneous 
scarifications between the joints of the feet, or above 
the feet or round the ankles. Incision, however, is 
dangerous, and must not be performed unless the 
patient is very strong. Avicenna says, " when the 
belly is full of water and the strength is well main- 
tained, then make an incision and let out the water, 
but little by little and not all at once." ' 

And it is specially to be noted that diuretics 
should be of a hot nature, and of such are anise, 
bishop's weed (ameos), marathrum (fennel), cumin, 
peony, wild carrot, spikenard, cassialigni, assarabac- 
cara [geum urbanum). Hence the lines, 

Assarabaccara, cassialignea, spicaque nardi 
Idropisim curant de causa frigidiori. 

And spica Celtica (lycopodium) balsam, squinanthuni 
{jzmctcs communis) are also good. 

c 2 


Diuretic herbs and roots of a hot nature are : 
nasturtium, hyssop, ebulus {sambucus ebuhis), apium 
macedonicum, levisticum, eupatorium (wood sage), 
wild parsley, fennel, juniper, aristolochia (both kinds), 
savory, dittany, absinth. Also cinnamon, sweet 
flag, and the like. Of a cold nature are all the 
sandal woods, endive and its seed, sow-thistle, scariola 
(this is apparently another kind of endive), epatica. 
The four greater cold seeds are those of capillus 
veneris (maiden hair), lettuce, portulacca, and scariola. 
Lithospermum and ivory turnings are also good. 

Of drugs which are valuable for either variety the 
hot or the cold are : spikenard, wood sage, maiden 
hair, endive, scolopendrium, hepatica, sandal wood, 
mastich, nutmeg, goat's milk whey, rhubarb {per ac- 
a'dens),for the liver is strengthened by all kinds of this 
drug, and the same may be said of agaric and cassia. 

The directions for treatment by incision are given 
on f. 41, where, at the end of a long list of remedies 
and treatment, he says : 

* If the dropsy is not cured by any of these, and 
its energy seems still unabated, an incision must be 
made three fingers ' breadth below the umbilicus. 
Care must be taken not to draw all the water off 
at once lest the patient suddenly die, as is laid down 
by Messue in the sixth book of his Particular Affec- 
tions in the Aphorism " Of those suffering from 
empyema {empici) or who are hydropic ". 

The manner of the incision is as follows : 

Let the patient sit in a slightly elevated seat, and 
let the belly be forcibly compressed by the hands so 



that the watery matter may descend as far as pos- 
sible. Then make an incision three fingers' breadth 
below the umbilicus with a sharp knife, the external 
skin being slightly elevated from the rest of the 
body, as far as Siphac, if the hydrops be from the 
intestines. If it come from the liver or the neigh- 
bouring parts make your incision to the right of and 
three finorers' breadth below the umbilicus. If from 
the spleen, make it on the left side. Lift up the 
skin lest Mirac be cut, then perforate Mirac, but make 
the hole in Mirac somewhat lower down than that in 
Siphac, so as to have them on different levels, that 
the water come not out continuously. Then put in 
a canula made of Q-old or silver or bronze. Then feel 
the patient's pulse, and if he be weak take out the 
canula and give medicine or dressing made of down 
(?) i^plumaccohint) dipped in wine or white of ^"g^. 
Make the patient lie down and give him chicken 
broth with spicey medicines, or food of easy digestion 
such as partridge, kid, or lamb. On the second day 
take off the dressing, replace the canula, and draw 
off some more water, and do this three or four times.' 

On f. 39 urine, it will be noted, is used as a purga- 
tive, but further on (f. 41 verso, col. i) he gives a 
prescription for the cure of a hydropic child which 
includes diuretics. This prescription being only for 
wealthy persons, he recommends that if the patient 
be poor he should drink his own urine in the morn- 
ing of every day. Urea, it will be remembered, has 
been comparatively recently introduced as a diuretic. 

Another foreshadowing of modern therapeutics is 
seen in his directions for the diet of hydropics {f. 40 
verso, col. ii). The diet should be ' tenuissima quia 
abstinentia hie est summa medicina '. Chicken broth 


made from an aged cock or hen is useful, and the 
patient should only eat once in the day. He con- 
tinues, ' Panis eorum non sit de tritico quia propter 
viscositatem oppilat, sit de furfure et non azymus 
cum modica salis quantitate.' Such bread ' concil- 
iaret sitim patienti'. He does not, however, recom- 
mend this bread in diabetes, although he notes that 
this disease is accompanied by a ' sitis canina . 

The mention of the small quantity of salt in the 
above passage, together with the following a line or 
two further on : ' et ideo panis de kokobeco decoctus 
oxomiae (? oxonlae) non valet quia nimis est salsus,' 
is worthy of note on account of the recently intro- 
duced treatment by * dechloridisation ' which has 
been of late years much in evidence in France. 

In a work by Dr. F. X. Gouraud with a preface 
by Professor A. Gautier entitled Que faut-il 
manger? published in Paris by Jules Rousset (1910), 
there occurs the following passage, p. 253 : 

' Plus nombreuses sont les indications du rdgime 
hypochlorure. C'est dans la nephrite, et surtout dans 
la nephrite avec oedeme, qu'il a d'abord ete pre- 
conise par Widal, et c'est la qu'il donne les plus beaux 
resultats. II amene souvent une rapide resorption de 
I'oedeme . . . Les beaux succes obtenus dans I'oedeme 
d'origine renale ont conduit a utiliser le regime hypo- 
chlorure dans tous les cas d'hydropisie, quelle qu'en 
soit I'origine, chez les cardiaques, les hepatiques avec 
ascite, meme dans les phlebites infectieuses (Chante- 
messe). Pour les premiers il est souvent utile sans 
etre curateur.' 


Freind In his History of Physick notes Gaddes- 
den's fondness for secrets, and it is true that he has 
many. But the Rosa Afiglica was written for 
medical men in the first instance, a fact upon which 
the author rather plumes himself in his preface, and 
therefore he has no hesitation as a rule in disclosing 
the composition of his secret remedies. 

Thus he describes a course of a preparation of 
Iris and of succits morellae. The iris was to be 
given one day and the succus morellae on the following 
day (f. 41 recto, col. i). He proceeds : 

' Hanc Medicinam Regalem voco et hae aquae 
sunt pro delicatis, pro dominabus et pro divitibus et 
sunt secretae et sine vituperio hominum ; nee debent 
doceri laicis, quia sunt de summis meis secretis ; 
quod si scirent homines vulgares vilipenderent artem 
et Medicos contemnerent' 

Again, f 40 recto, col. i, he says : 

* Pono aliquando loco ligni aloes spicam nardi, et si 
substantia hepatis non sit resoluta procul dubio 
liberatur, sicut sum expertus in viginti et amplius et 
est electuarium plus valens in quavis hydropis specie, 
quam species Diatrionsantalon quia recipit tantum 
quantum confectio Diatrionsantalon: Et est electua- 
rium idropicorum mihi specialissimum nee debet 
dari nee administrari nisi accepto salario.-' 

Had he known him, Gaddesden would have agreed 
with Matthews Duncan, who used to say to his 
students, ' If you don't believe in yourself, nobody 
else will,' for he never fails to make the most of his 
successes. On f. 124 recto, col. i, he gives a pre- 


scription for the stone which contains some thirty 
different drugs, and this he says : ' ego voco syrupum 
raphaninum, qui mihi fecit infinitum honorem in 
quodam calculoso quern alii demiserunt et cum isto 
solo curavi eum.' It must be owned that this reads 
rather like the advertisements of modern quacks, but 
then they do not disclose the ingredients of their 
remedies, whereas Gaddesden does. 

One of his specially valuable secrets was a pre- 
scription for extracting teeth, for which he remarks, 
' grandem pecuniam accepi a barbitonsoribus,' and it 
was this, ' Capiatur rana viridis quae de arbore in 
arborem scandit, et in Provincia satis copiose reperi- 
tur, sumatur ipsius adeps et eo liniatur dens quisquis 
sit et statim excidet' (f 155 verso, col. i). 

He does not profess to have personal knowledge 
of the efficacy of this remedy in human beings, but 
he adds as a proof that cattle who eat these frogs in 
the grass lose all their teeth. That tree-frogs do 
not live in the grass is a small matter which does not 
trouble him, and most likely the mediaeval patient 
would prefer a trial of this remedy to the more 
purely surgical one recommended, namely, to destroy 
the tooth, * stylo ferreo ignito.' This being applied, 
the tooth * post aliquod tempus cadit in frusta '. 
Sundry charms for toothache are also given, which 
will be found below. 

Possibly the best known .passage in the Rosa is 
one which occurs in the section upon small-pox, for 
the remedy, after having been in abeyance for 


centuries, has now come in again in a modified form 
and has both supporters and detractors ; ^ namely, 
the red light treatment. Gaddesden was probably 
led to try it owing to the mention of it by Gilbertus 
Anglicus, who notes it as an old woman's remedy as 
follows. The passage can be found in the Lyons 
edition of the Compendium Medicinae, 15 10, fol. 348 
verso, col. i : 

' Vetulae provinciales dant purpuram combustam 
in potu, habet enim occultam naturam curandi vari- 
olas. Similiter pannus tinctus de grano.' 

Anyway, Gaddesden met with success in at least 
one case, and, moreover, his patient was a scion of 
Royalty. Here is his account (fol. 51 recto, col. ii) : 

' Deinde capiatur scarletum rubeum, et involvatur 
variolosus totaliter, vel in panno alio rubeo, sic ego 
feci de filio nobilissimi Regis Angliae quando patie- 
batur istos morbos, et feci omnia circa lectum esse 
rubea, et est bona cura, et curavi eum in sequenti 
sine vestigriis variolarum.' 

It will be noticed that Gaddesden claims that this 
treatment cures the disease and prevents pitting as 
well, whereas the moderns who have tried it claim 
that it prevents pitting, but not that it shortens the 
course of the disease, qua small-pox, but only by 
preventing mixed infection from suppuration. 

^ Finsen, Brit. Med. Journ., June 6, 1903 ; and Ricketts and 
Byles, The Lancet, July 30 and Sept. 17, 1904. 



The section upon phthisis (f* 64 verso) is very 
clear, and shows, as is usual with Gaddesden, good 
clinical observation. 

He defines phthisis as * Morbus pulmonis, tussim 
commovens et Hecticam causans '. Every phthisical 
patient is hectic, but every hectic patient is not 
necessarily phthisical. This observation was virtu- 
ally correct in Gaddesden's day ; but his explanation 
is naturally in accordance with the erroneous physio- 
logy of the age. As the lungs are ulcerated, they 
cannot sufficiently ventilate the heart, and whenever 
the lungs expand the wounds in them increase, then 
sanies is drawn back and'fumi aucti, et nonsufficien- 
ter eventati ' go all over the body, inflame it, dry it 
up, and consume it, and so cause hectic. But it does 
not follow that in every case when a man is ' con- 
sumed ' that his lungs are ulcerated, wherefore every 
hectic is not necessarily phthisical. 

With regard to treatment he is quite modern. A 
real cure can only take place before the lung has 
broken down 'ante confirmationem et ante exul- 
cerationem saniosam . . . . et ante ejus foetorem et 
descensum ad profundum aquae '. 

He was aware that hectic was not an essential 
part of phthisis, although the latter caused the former, 
for in his directions for treatment he gives one set 
of instructions for treating phthisis and another for 
treating ' putridam febrem vel Hecticam conjunctam'. 



' For the cure of this,' he says, ' the reader must refer 
to what I have said about Rheuma, In fact this 
heading must be frequently referred to.' As Rheuma 
is defined as ' fluxus humoris mentis a caplte ad partes 
subjectas et vicinas ', and that to its malign influence 
was due deafness, tinnitus, blindness, ophthalmia, 
lippitudo, foetor and polypus of the nose, angina, 
phthisis, pleurisy, peri-pneumony, ' fastidium,' ' fluxio 
cerebralis ventris,' arthritis, and, in fine, disease of 
any organ except the spleen, it is obvious that the 
chapter treating of Rheuma must be studied pro- 
foundly. Moreover, he says, ' Est enim Rheuma 
quasi mater omnium morborum.' And it was of 
three kinds — Catarrh, branchus, and coryza, which 
are defined in the following verses : 

Ad fauces branchus, ad nares esto coryza, 
Si fluit ad pectus dicatur rheuma catarrhus. 

To return to phthisis, Gaddesden gives the follow- 
ing thirteen indications for treatment, and they might 
almost have been written to-day : 

' (i) Keep in check the catarrh and the rheumata ; 
(2) cleanse the body ; (3) divert and draw away 
the matter (of the disease) to a different part ; {4) 
strengthen the chest and the head so that they do 
not take up the matter, and that it there- multiply ; 
(5) cleanse and dry up the ulcers and expel the matter 
from them ; (6) consolidate them ; (7) restrain and 
cure the cough by using demulcent drinks with oint- 
ments and stupes ; (8) assist the patient to sleep ; (9) 
strengthen and bring back the appetite ; (10) keep in 
check the spitting of blood ; ( 1 1 ) do what can be done 
to make the breathing more easy and to remove the 


asthma and the hoarseness ; (12) regulate the way of 
life so far as the six non-naturals; (13) cure the 
putrid or hectic fever which goes with the disease.' 

(The six non-naturals were, air, food, exercise, sleep, 
the excretions, and the passions.) 

He gives a gigantic list of drugs and remedies in 
regard to the first eleven indications for treatment 
and then comes to the regimen. 

' As to food, the best is the milk of a young 
brunette with her first child, which should be a boy ; 
the young woman should be well favoured, " bene 
complexionata et non utatur coitu," and should eat 
and drink in moderation. Failing a wet nurse, the 
milk of other animals might be used in the following 
order of choice : the ass, the goat, and the cow. If 
the patient liked, he could take his milk straight from 
the udder ; if not, it was to be boiled with a little salt 
and honey, so that it should not coagulate in the 
stomach, for in that case it was a very poison (" tunc 
est quasi venenum "). Wine and milk should not be 
taken together, for wine coagulates milk in the 
stomach. If the patient has pain and colic after his 
milk, it does not agree with him. Therefore the dish 
should be washed with hot water and placed in 
another vessel full of hot water and the milk 
milked into this, for then it is converted and changed 
quickly and becomes less harmful.' 

The patient could also have wine if it were new, 
and provided that he were not very hectic. He 
should, further, live in a dry, clear, and still atmo- 
sphere and at a high elevation ; and here Gaddesden 
reminds his readers that Galen used to send his 


phthisical patients to a high mountain near Sicily 
where there was perpetual fire. 


Gaddesden's account of leprosy is particularly 
interesting, from several points of view. It may be 
taken for granted that the terms' lepra and ' leprosus' 
were used in the Middle Ages to signify various 
chronic skin diseases, and possibly syphilis as well as 
true leprosy. But that true leprosy was very prevalent 
in mediaeval times is undoubted, and, moreover, from 
the descriptions left us by mediaeval writers, it is 
plain that the disease was the same then as now. 

Here is his list of the signs of leprosy (f. 56 verso, 

'The signs of leprosy are many, and in the first 
place come the prodromal signs, while the prognostics 
are yet concealed (" primo sunt signa precedentia 
prognostica occulta tamen "). Secondly come the 
obvious and manifest signs of the presence of the 
disease ; thirdly come the signs reminiscent of a 
former materia {inde antecedentis) ; fourthly signs 
showing forth an accompanying materia. 

In the first place you must note if the usual red 
colour of the face tends towards a black hue, and if 
the patient suffers from gutta rosacea in his nose or 
his face,>if his breath undergoes a change and is 
sometimes foetid, if he sweats much and his hair 
begins to get thin and sparse. Also look out for a 
change in his manner, he may become melancholic 
and vicious and tricky {doiosus). He will be anxious 
and will avoid society, and will fancy that he is a 
leper. Such a mental condition should be avoided, 


for imagination in one disposed to this disease very 
often actually brings it about, especially when com- 
bined with errors of diet. Sometimes the patient 
suffers from horrible dreams and awakes in a fright, 
so that he dare not sleep alone. He may dream 
that he feels a heavy weight on his chest as do those 
who are afflicted by an incubus, and yet this is no- 
thing but the weighty " material " dispersed through- 
out the body. He may dream that he cannot run, or 
that he is falling into some foul and filthy place 
(" somniat se currere non posse, vel cadere in loco 
turpi fetido sterquilinoso ").^ 

Again, if lice are multiplied on his body from some 
intrinsic cause and not an extrinsic one, as is the case 
with those who sleep in a hair shirt, if he take no care 
for his body by bathing and the like, if the itch and 
pustules and morphea appear all over his body, and 
if generally speaking he is in a filthy condition (" Si 
incipiat fieri fetida corporis dispositio "), then in the 
case of such an one I say that it may be prophesied 
that he is disposed towards leprosy, that in him 
leprosy is hi posse (inchoata). As yet, however, he 
may mingle with his fellows, though not so safely as 

He quotes from Joannes de Sancto Amando a list 

of absolutely certain signs of leprosy (' signa valde 

certa demonstrativa leprae '). These are : 

(I The colour of the body tending towards black, 

^ It is worth while, as a contrast to this bald description, to 
quote the magnificent passage dealing with the same dream of 
inability to move, given by Vergil, Aen. xii, lines 908-912 : — 
Ac velut in somnis oculos ubi languida pressit 
Nocte quies, nequicquam avidos extendere cursus 
Velle videmur, et in mediis conatibus aegri 
Succidimus ; non lingua valet, non corpore notae 
Sufficiunt vires, nee vox aut verba sequuntur. 


laboured breathino^ and a husky voice (" strictura 
anhelitus et vocis ") frequent sneezing, a nasal tone of 
voice, thinness and falling of the hair, a foul-smelling 
sweat and breath . . . swelling of the face and of the 
limbs, " rotunditas " of the eyes, a greasiness of the 
skin, so that a drop of water will not stop on it but 
runs off, and insensibility of the calf is a common 

He proceeds : 

' I can add many to these, for instance, when the 
little and middle fingers and toes, or even the others 
next to them, feel cold and sleepy, as if sensation 
were wanting, and when, as sometimes happens, the 
anaesthesia extends to the skin between the fingers 
or toes, and reaches up the arm, or in the leg as far 
as the hip, there is a certain sign of leprosy. . So are 
impetiginous eruptions. If these are cured, the places 
remain bald, or at most have a few thin hairs on 
them. Formication, tickling, and pricking are felt.' 

He mentions the lividity and distortion of the nails 
and the falling of the eyebrows, the ulceration of the 
septum nasi, the fixation and dropping off of hands 
and feet, and the thickening of the lips. 

He evidently appreciated the fact that the sentence 
of isolation was a most serious affair, for he says : 

^ ' No one is to be adjudged a leper and isolated 
from all his fellows until the appearance and shape 
of his face be destroyed. And therefore " cancer " in 
the feet and a foetid skin disease should not be 
taken as a proof of the disease even when accom- 
panied by a nodular eruption, unless this be on the 
face. And because many are leprous before the 
appearance of these signs, be it known that there are 
three signs common to every form of leprosy (" Com- 



munia in omni lepra"). ^ The first is to take three 
grains of salt and to place them on some blood (from 
the suspected patient), and if the blood be infected 
straightway it will be dissolved {statim resolvetui'\ 
but if it be not infected this will not happen. The 
second is for some of the blood to be rubbed on the 
palms of the hands, and should it squeak or be more 
sticky than usual, this is a sign of corruption. 
Thirdly, take some blood and place it in very clear 
water, if it swim on the top it is infected, but if it 
sink to the bottom it is not so.' / 

He mentions this thickening and rapid clotting of 
the blood in three or four different places, and it is 
interestine to note that Boeck and Danielssen have 
noted a large increase in the fibrin ferments of the 
blood of lepers.^ 


Gaddesden, in common with Gilbert and other 
medical writers both before and after his own time, 
such as Mirfield (circa 1387), did not disdain to make 
use of charms and empirical remedies. Thus in 
his section upon toothache, p. 153 recto, col. ii, he 
says : 

^ There were four varieties of Lepra, which Gaddesden em- 
bodies in verse as follows (fol. 56 recto, col. i) : — 
Sub specie tetra deturpat corpora Lepra : 
Tiria prima datur, de flegmate quae generatur : 
Turpe pilos pascens Alopicus sanguine nascens ; 
Fitque Leonina, colera fervente canina ; 
De mel. (ancholia) fit tristis Elefantia tristior istis. 

- Art. * Leprosy ' in AUbutt's System. 


' Modo fiant emperica quae aliquando curant in 
principio. Radix apii coUo suspensa dolorem dentis 
toUit. Idem facit radix piloselle majoris et minoris, 
et radix diptami.' (Pilosella is Mouse-ear Hawkweed.) 

Then he gives a selection of charms and prayers: 

' Again, write these words on the jaw of the patient: 
In the name of the Father, the Son and the Holy 
Ghost, Amen. + Rex + Pax + Nax + in Christo Filio, 
and the pain will cease at once as I have often 

Again, whosoever shall say a prayer in honour of 
St. Apollonia, Virgin, (Feb. 9) shall have no pain in 
his teeth on the day of the prayer. The same thing 
is said of St. Nicasius the martyr (Oct. i r). 

Again, draw characters on parchment or panel and 
let the patient touch the aching tooth with his 
finger as long as he is drawing, and he is cured. 
The characters are made in the shape of running 
water by drawing a continuous line, not straight but 
up and down. Three lines are to be drawn in the 
name of the Blessed Trinity and this is to be done 

Again, if the many-footed " worm " which rolls up 
into a ball when you touch it is pricked with a needle, 
and the achino: tooth is then touched with the needle, 
the pain will be eased. 

Again, some say that the beak of a magpie hung 
from the neck cures pain in the teeth and the uvula 
and the quinsy. 

Again, when the gospel for Sunday is read in the 
mass, let the man hearing mass sign his tooth and 
his head with the sign of the holy Cross and say a 
pater noster and an ave for the souls of the father 
and mother of St. Philip, and this without stopping; 
it will keep them from pain in the future and will 
cure that which may be present, so say trustworthy 

1302 D 


authorities (" et preservat a dolore future et curat pre- 
sentem, secundum veridicos").' 

One of his numerous remedies for epilepsy is as 
follows. The rationale of it is interesting (f. 78 
verso, col. i). After giving directions for a cuckoo 
to be roasted until it can be powdered, he says that 
the powder is to be blown into the patient's nostrils 
at the time of the paroxysm and he will recover. 
Or the remedy may be used in food or drink either 
before or after the paroxysm. Again, the patient 
may wear the head of a cuckoo suspended from 
his neck, which will preserve him from the fall or 
will at least retard and greatly alleviate it. * I have 
tried this remedy,' he says, 'with success in many cases 
of children who could not take medicine. And the 
reason for this doing good is that the cuckoo suffers 
from epilepsy every month, and therefore, according 
to some, it has a peculiar property of attracting the 
epileptic " materia " to itself, just as rhubarb attracts 
the jaundice {coleram)! His advice to epileptics 
as to their habit of life is sound, and may shortly 
be summed up in the aphorism, ' all overs are evils.' 

In another charm for bleeding at the nose (f. 10 
recto, col. i) he quotes from Gilbert in the third book 
of his Practica. The physician is to say ' In nomine 
Patris et Filii et Spiritus sancti, Amen ; Caro cum 
Calice confirma sanguinem israhelitae '. At the 
same time he is to pour out water nine times and 
strain it through the shirt of the patient. Then the 
shirt is to be given to the patient or to his messenger, 


who will in turn hand it to the patient. (' Novies 
versando aquam et colando per camisiam infirmi, 
quam tribuas ipsi patienti vel nuntio nomine infirmi, 
quam tribuat ipsi patienti.') 

In the account of semi-tertian fevers (Emitritei), 
f. 16 verso, col. i, he gives a prescription from Sera- 
pion : ' Item in libro de proprietatibus rerum, dicitur 
quod smaragdus suspensus ad collum patientis curat 
emitriteum,' In this connexion it may be noted that 
over two hundred years after Gaddesden's time, 
Cardan, who was born in 1508, gives the following 
advice to his sons : ' Ferte hyacinthum in digitis ad 
somnum conciliandum, et adversus pestem et fulgura. 
Smaragdum collo pueris suspendite ob comitialem 
morbum, cerebrum enim confirmat.* 

For the cure of scrofulous glands (f. 34 verso, 
col. i) he gives a long list of remedies, including an 
application made from snails and liquorice. In case 
of failure of these remedies he proceeds, ' then let 
him go to the king to be touched and blessed by him, 
for this disease is called " morbus regius ", and the 
touch of the most noble and most serene king of the 
English is of avail.' Even this may fail, and in that 
case the aid of a surgeon must be sought. 

With the above may be compared the following 
prescription, written about 1500 a.d. in an English 
book of Horae, circa 1440: 

'Pro morbo Caduco. — Take xij candylls of ye 
length of ye chefe joynt of ye hande, and the xiij 
candyll as long as iii of the sayd xii and gar synge 

D 2 


on messe of the holy ghost and gar leyght the sayd 
xii candylls and apun every candill wryhte on name 
and apun the lange candill J he and apun the ryght 
syd sante peter and apun ye lyeft syd sante paulle 
and apun ylke on of the oyer candills sette a name 
of the xij appostylls so that vi stand on the on syd 
and vi apon the toyer . . . and heyd whilke of the 
candills indureth the longest and to the same Appos- 
tyll the seky body must woue to fast the evyn to 
brede and water while he levys.' ^ 

Journey Matters 

As an illustration of the hygiene of the fourteenth 
century, Gaddesden's instructions to travellers may 
be quoted. They are given on f. 171 recto, col. 2 : 

' Those who are going on a journey, or who cross 
the seas, or are going to the wars, or on pilgrimage, 
or to the schools, or market, or to see their friends 
or acquaintances, or (in the case of medical men) the 
sick should do as follows. As a general instruction 
applicable to all these cases, it is good to begin 
by being bled, or by " taking medicine " [farinacari) 
and fasting, so that the body may be cleanly 
disciplined, otherwise there is a risk of fever, or of 
an apostema, of a flux or of a ruptured blood-vessel. 
So Galen intimates in his commentary on the first 
book of the Aphorisms. In spring-time madness 
and melancholy are to be feared. 

In warm weather, thirst and heat are best resisted 
as follows. Take sugar of roses or violets or water- 
lilies or diaci coreata made from conserve of chicory 
flowers and sugar, or else take " candi " or tamarinds 

^ M. R. James, Catalogue of MSS. in the Fitzwilliam Museum, 
MS. 51. 


or barberry or sorrel and partake of these often on 
the journey. The three sandal woods or diadra- 
gantum cold, or diapapaver infused in cold water and 
\Q^^\^){i)ifrigidata)2Lr^ also good. Again, a drink may 
be made from sugar and vinegar or from pomegranate 
wine, or syrup of roses or violets or water-lily, or 
vinegar syrup, or the bread may be dipped in vinegar 
and other things may be eaten as laid down in my 
first book. If any one have drunk too much, if it be 
a man the testicles should be washed with salt and 
vinegar, and if it be a woman, the breasts, also let 
them eat the leaf or the stalk or the juice of a 
cabbage with sugar. 

If the air is hot or foul smelling, then let the way- 
farer smell camphor or roses or violets, and in very 
hot weather let him smell musk or wood sage 
{ambrosia), laudanum, camomile, laurel leaves or 
marjoram. Let him hold his nose if fetor is present, 
and on rising let him eat a toast in aromatic wine or 
chesnuts roasted with the same. 

After hard work in hot weather the feet must be 
washed with water in which has been boiled camomile, 
fennel, and betony. Wine of artemisia root should 
also be taken, for in this way the fatigue and 
weariness will almost completely disappear and will 
hardly be felt. Let him carry with him some 
artemisia and a stalk of agnus castus, for by so doing 
he will not stumble by the way, nor will he be tired 
on the day that he shall do this. And before he 
goes out in the morning he should annoint himself 
with aragon and marciaton. He should eat roasted 
meat and garlic with good wine or pigmentum ; he 
should also take dianthus and diatriton and diaofalin- 
gale pliris with muse. 

If he be a poor man let him take three graines of 
olibanum and pepper, or six leaves of mint, and let 
him smell laudanum and olibanum on account of the 


rheum. He should not go to work immediately after 
eating, nor fill himself up (with drink (?)) at night. But 
if under such circumstances he should sleep well in 
the night and the morning let him after a little fast 
until the following day until the effects of his debauch 
have passed away {"nee repleatse in nocte,etsi sic bene 
dormiat in nocte et mane, post paulatim incedat cum 
abstinentia sequentis diei, quousque crapula recedat"). 

The feet should always be washed with hot salt 
water, dried, and then annointed with goat's or ram's 
fat, and in the same way the perinaeum {periloneon), 
on account of the excoriations which may have 
occurred during the journey. 

Linseed mucilage or flea wort {jysilliuni) may be 
used for this latter purpose, although some use a 
candle with good results. According to Galen in 
his Regimen Sanitatis, those who work hard ought to 
take baths of very hot water, so hot in fact that at 
first sicjht it looks boiling;. 

If, however, a man be not accustomed to this he 
will do well to foment his extremities with a decoction 
of roses, violets, and camomile, to rub them gently 
and to live temperately. Those who travel in winter 
should wear a garment made of two layers of fabric, 
wadded with cotton next to the shirt lined with 
fox, lamb, or rabbit skin.^ On their head let them 
wear a cap lined with thick budget 

^ The meaning of this last sentence is very obscure. I owe 
the translation to the efforts of Sir G. Warner and his assistant in the 
Manuscripts Department of the British Museum, who spent much 
time and trouble in endeavouring to solve the mystery. I should 
add that they expressed themselves as by no means satisfied with 
the result of their efforts, and therefore it is as well to give the 
original Latin. It appears on the verso of f. 171, col. i : 'Et 
portent itinerantes in hiemi vestem cum duplici tela et coto in 
medio punctato juxta camisiam.' 

^ Budge, Latin Bogettus, a kind of fur. 


They should also have a hood coming down as far 
as their shoulders, or they may wear a thin kerchief 
on their head. They should keep their feet warm 
and dry so far as possible, and dry them carefully 
before going to bed. 

Let them take care of the fever which arises from 
(?) flatulence {ventositate) and the sun, and let them not 
go close to the fire when they are very cold, but let 
them rub their limbs for a little, not far from the 

Water should not be drunk while on the way, in 
any manner, for that brings about an " apostema et 
febrem oppilando quia transire moratur rem " ; (?) by 
checking the fever, prevents it from " coming out." ' 

It is worthy of note that the extremely hot bath, 
recommended by Gaddesden, has been for centuries, 
and still is, in use by the Japanese. Pliny, however, 
in his attack on the medical men and the medicine 
of his day, Hist. Nat. XXIX, cap. viii, objects to 
them, ' ilia quae sani patimur . . . balineae ardentes, 
quibus persuasere in corporibus cibos coqui, ut nemo 
non minus validus exiret, obedientissimi vero efferren- 


Comparatively a small portion of the Rosa is 
devoted to surgery. Gaddesden's account of the 
operation of tapping has already been quoted. 
Other operations described by him are lithotomy, an 
operation for hernia, and the reduction of dislocations. 

' Whether efferre here simply means * to carry home', or is 
used in the technical sense of 'to carry out for burial', is un- 


Of the last named, the account of dislocation of the 
jaw is worthy of note. 

He describes it as a rare accident. It may occur 
from direct violence or from frequent yawning, or 
from trying to take too large a mouthful of anything. 
And therefore men bless themselves when they yawn, 
lest this accident should happen, or even sudden 
death. He adds, ' I once saw one of my household 
who during his convalescence from a fever yawned so 
often, and opened his mouth so widely in doing so, 
that he dislocated his jaw.' To reduce the disloca- 
tion, an assistant should hold the patient's head 
while the surgeon puts his thumb into the mouth, 
and after moving the jaw from side to side he must 
extend it suddenly until the upper and lower teeth 
are on a level, then let him reduce it. Another 
method, which is successful if carried out as soon as 
the dislocation has happened, is for the patient to 
give himself a sharp blow on the chin, in a backward 
and at the same time upward direction. A friend 
who is present may be asked to do this, Gaddesden 
adds that he saw this procedure followed with 
success in the case of one of his friends who dislocated 
his jaw at the table. If reduction is difficult and 
there is much muscular resistance {ditrities) the 
patient may be put in a bath and the ' durities ' 
rubbed with oil. Then the patient should lie on his 
back and the surgeon should place his thumb in the 
mouth as aforesaid. The assistant, standing behind 
the patient, is to steady the condyles of the jaw just 


under the ears, and when the surgeon has extended 
the jaw sufficiently he can press them into place. A 
bandage must then be applied. The weariness of 
convalescence described here must often have been 
in evidence during the Middle Ages, when few 
people could read, and even when they could books 
were scarce. The mention of sudden death from 
yawning is due to the belief that it was possible for 
evil spirits to enter the system through the open 


As regards the treatment of wounds, he notes the 
following points. The object of the surgeon is to 
(i) remove any weapon, or any other foreign body 
which may be in the wound ; (2) stay the bleeding ; 
(3) make choice of a proper dressing ; (4) restore 
the continuity of the tissues ; (5) bleed and drug the 
patient, if necessary ; (6) attend to his way of life ; 

(7) avoid, if possible, the development of a dyscrasia 
or a hot swelling, and cure them if they do occur ; 

(8) bring about a comely (pulchra) cicatrix, and 
remove proud flesh if it should arise. 

If these counsels were those of perfection in 
Gaddesden's day, it is yet noteworthy that the 
mediaeval surgeon knew what he should do. Almost 
identical directions are given by Lanfranc, (od.) 1 300, 
and the methods of dressing wounds as described by 
both Gaddesden and Lanfranc are also practically 
the same. One important difference, however, is to 


be observed between the practice of the two, and 
Gaddesden is rather severe upon * modern operators 
who operate after the ancient methods and in ac- 
cordance with Lanfranc and Roland and Bruno '. 

And the point on which they differed was as to 
the treatment of a wound involving a bone. Lanfranc 
taught ^ that, in case of a wound involving the bone, 
the flesh should never be sewed about the bone, 
until the bone be quite repaired. Gaddesden says 
that this treatment is quite wrong ; and adds (fol. 157 
verso, col. 2) : 'In the case of an arm, if any part 
of it remain in continuity, and the wound be quite 
recent, it should be at once joined up, bone to bone 
and flesh to flesh, so that so far as possible the 
original condition may be restored. Then it should 
be carefully sutured and a dressing of hot white 
wine, as hot as the patient can bear it, applied as 
I have described above.' It would be interesting 
to know the fate of a bad compound fracture, treated 
in either manner, in mediaeval times, but Gaddesden's 
method is certainly preferable to Lanfranc' s. 


Mediaeval writers had one specially good side to 
them, in that they were fond of giving reasons. 
That the reasons were often quite incorrect was due 
to the limitations of the times in which they lived, 
but the tendency was a valuable one. Gaddesden, for 

^ Science of Cirurgie, English translation circa 1380, E.E.T.S. 
original series, No. 102, p. 48. 


instance, is generally careful to give the derivation 
of the name of a disease. Thus in his description 
of phthisis he says, ' It is called ptisis as if from 
ptesis, which is retention, because the disease inhabits 
the body for a long time. Or else it is called piisis 
from tussis, because it itself is caused by the cough.' 

Again, ' Epilepsy is so called from epi, which 
means above, and ledo, for it is a lesion of the upper 
parts, i. e. the head. It is also called ieranosos, from 
iera, i. e. sacred, and noceo, namely, a disease which 
hurts the noble parts.' Again, he says of hernia 
(fol. 166 recto, col. 2) : 'It is called hernia qtiasi 
rumpens euia, i. e. the intestines, or else the etiia are 
the paniculi and the membra nervosa. Or else it 
is called hernia, quasi heredem necans, because it 
impedes generation. Or else it is so called from its 
breaking through the thin membrane which is spread 
over the intestines, or else hernia from haerens 
because the intestines do not adhere to the pellicle 
to which they should adhere.' 

In speaking of the Arts course at Oxford it was 
mentioned that Greek was practically unknown, and 
a remarkable proof of Gaddesden's ignorance of 
that tongue is afforded by a passage (fol. 99 verso, 
col. i) in his section on Sterility, which, after a pre- 
scription containing chelidonia, runs as follows : ' et 
hie nota quod chelidonia dicitur quasi celi donum et 
ipsa aufert maculam oculorum : et hirundo quaerit 
earn quando ejus pulli non vident et matricem mundi- 
ficat' It is impossible that any writer save one 


entirely ignorant of Greek could have given the 
absurd derivation of chelidonia from ' celi donum ' 
and immediately afterwards have mentioned the 
swallow, x^^^^^^- 

The sparkle of the following derivation evaporates 
in translation, so I have left it in the original. 
'Paritoneon' is perinaeum (fol. 30 verso, col. i) : 
' Paritoneon dicitur a " pari " quod est juxta, et 
"tonoas" quasi juxta tonantem, quia est juxta anum 
scilicet intra virgam et anum.' 


As is usually the case in mediaeval treatises on 
Medicine, the J^osa contains a section entitled, ' De 
Decoratione.' This grives instructions for the cure 
of facial blemishes such as freckles, pustules, sunburn, 
and the like. There are also prescriptions for com- 
plexion washes and preparations for making the 
breath and the body smell sweet. Gaddesden, how- 
ever, with the common sense which he usually dis- 
plays, mentions that in addition to using scents such 
as myrrh, amber, and musk it is of great importance 
to avoid over-eating or the eating of anything which 
is likely to cause eructations. Moreover, any one 
who studies to possess a sweet savour should take 
baths and see that his underclothing is clean and 
frequently changed. He concludes this section by 
saying, ' These things have I written for delicate 
women and for ladies, and indeed for noble men, 
wishing to give them pleasure, but now I have said 


enough. You will find much other information in 
the works of those who have written about Cosmetics 
or women's complexion colourings [fucis)! 

He gives no names, but he possibly had Arnold 
de Villanova in his mind. That able and some- 
what turbulent personage,, who was at once physi- 
cian, alchemist, and theologian, had no love for 
women. In the proem to Book H I of the Breviarium 
Praciicae'^ he says : ' In this book I intend, God 
being my helper, to treat of those sicknesses which 
specially concern women, and as women are in 
general venomous animals I shall follow it up with 
a treatise on the bite of venomous animals.' Despite 
this very ungallant opinion, his works contain a long 
treatise entitled de ornatu mulierum, together with 
its sequel, de Decoratio7ie. This contains innumer- 
able prescriptions for depilatories, hair dyes, com- 
plexion washes, and applications to remove wrinkles 
whether on the face or on the belly after childbirth. 
There are also prescriptions for making the breasts 
firm, together with others dealing with matters of 
an even more intimate nature. 

Gaddesden's Theological Degree 
Besides being a Doctor of Medicine, Gaddesden 

^ This treatise was generally ascribed to Arnold de Villanova, 
and in Cap. 5 1 of Bk. I he calls himself Arnold, but the author- 
ship is doubtful. Much indeed of the matter professedly written 
by him probably was not so, and the Cautelae Medicorum were 
almost certainly not. I have used the Basle edition of the Opera 
Omtiia, 1585. 


was a Bachelor in Theology and held sundry 
ecclesiastical benefices. It does not, of course, follow 
from this that he was in full orders, and indeed 
various Councils fulminated against the clergy, both 
regular and secular, leaving their first estate and 
practising either civil law.or medicine. 

In the Sacrorum Conciliorum Collectio'^ there are 
various decrees against such practices. 

Thus the Sixth Canon of the Council of Rheims, 
1 1 3 1 , inveighed against monks and regular clergy 
who despised the rules of the blessed Benedict and 
Augustine, and who practised law and medicine for 
worldly gain. The leech was looked upon as being 
immodest. ' Cumque impudicus oculus impudici 
cordis sit nuntius, ilia de quibus loqui erubuit honestas 
non debet religio pertrectare.' Practice in these 
two faculties was therefore forbidden, and bishops, 
abbots, and priors who connived at the custom were 
to be degraded. 

The Lateran General Council of 1139 repeated 
this canon almost word for word, and the Council of 
Montpellier in 1162 contained the following: 

' Prohibuit praeterea sub omni severitate eccle- 
siasticae disciplinae, ne quis monachus vel canonicus 
regularis aut alius religiosus ad seculares leges vel 
physicam legendas accedat.' 

Again, the Lateran Council of 12 15 forbade sub- 
deacons, deacons and priests to practise any surgery 
which involved cutting or burning. These canons 

^ Ed. J. D. Mansi, Venice. 


were, however, ig-nored to a great extent. Theodoric, 
for instance, was a bishop as well as surgeon to 
Innocent IV. 

In the Papal Letters (Rolls Series) are the follow- 
ing entries : 

' To John de Gadesden. Provision of a canonry 
at Chichester with reservation of a prebend, not- 
withstanding that he is Rector of Norton in the 
Diocese of Lincoln.^ 

Concurrent mandate to the Bishop of London, the 
Prior of Lewes, and the Dean of Hereford. 

To John de Gabshede, Master of Arts and of 
Medicine. Reservation of a dignity in the gift of the 
bishop-chaplin of London, he being a Canon of the 
same with expectation of a prebend and Rector of 
Cheping Norton, which last he is to resign.^ 

Concurrent mandate to the Abbot of Leicester, 
the Dean of York, and another named. 

To the Bishop of Winchester. Mandate to provide 
to John de Gatesden, Master of Arts and Medicine 
and Bachelor of Theology, a canonry of London 
with reservation of a prebend : notwithstanding that 
he is Rector of Chipping Norton, value 40 marks, 
which he is to resign.' ^ 

The prebend which Gaddesden eventually ob- 
tained in London was that of Wildland, and according 
to Le Neve he was appointed in 1342. 

Hennessy says : ^ ' Prebend of Wildland. This 
prebendary had the eighth stall on the left side of 

^ 1333, 2 non Dec, Avignon, 

^ 1333, 10 Kal. Oct., Avignon. 

' 1336, 3 non Jul., Pont de Sorgue. 

* Novum Repertorium. 


the choir, and the corps of his prebend is in the 
parish of Tilhngham in Essex. The Psalms for 
daily recitation were the 17th to the 21st inclusive.' 
Gaddesden's predecessor was Robert de Redeswell, 
and Hennessy gives the date of Gaddesden's appoint- 
ment to the prebend as 1332, which is probably 
a misprint for 1342, as in the papal letter above 
quoted, dated 1336, reservation of a prebend in 
London for him is mentioned. 

The ' Rosa '. General Remarks 

The style of the Rosa may be said to be popular, 
although Gaddesden treats the various diseases after 
a definite arrangement. But just as Master Nicolaus 
Scyllatius told Ambrosius that the book could be 
read again with pleasure, so any one who reads it 
nowadays will constantly come across passages 
which have a delightful freshness in them. Take 
a few. On fol. 144 recto, col. 2, he gives a prescrip- 
tion for weakness of sight. Among other things it 
was composed of tutty quenched fifteen times in the 
urine of a virgin youth, rose water, balsam, and 
white wine, together with marjoram, fennel, spikenard, 
long pepper, and lign aloes. This was to be mixed 
with the gall of a crow, a swallow, or a hen, and then 
rubbed up with honey. The patient was to take it 
partly as a food and partly as a coUyrium, and 
Gaddesden adds, ' It will make him see small letters 
to the end of his life, and the contents in urine, and 


the veins in the arms. And therefore it is of great 
value to all barber surgeons.' 

Again (f 127 recto, col. i) : ' Diabetica passio est 
immoderatus fluxus vel exitus urinae per renes, cum 
vehementia sitis, et vocatur anglice *' candepisse".' 

At first sight this passage would seem to imply 
that the commonly received opinion that Willis was 
the first to identify sugar in diabetic urine was wrong, 
and that its presence was commonly known in the 
fourteenth century. For candi (the question of e or 
i is of no moment) is constantly used by Gaddesden 
to mean some preparation of sugar or syrup, e. g. on 
ff. 6^] v., 68 r. and v., 98 v., 128 v., and 171 r. But 
a reference to the MSS. shows that the word is 
a misprint and should really be chaudepisse. MS. 
Sloane 280 (Brit. Mus.) has anglice chaudepisse, 
Sloane 1067 has gallice chaundepisse, and Sloane 16 1 2 
hdiS gallic e chaudepisse. Or (f. 168 verso, col. i) : 

' Incipit liber 4tus de morbis particularibus. 

Liber quartus erit brevis de prius omissis morbis 
qui sunt particulares ; quia particulariter eveniunt 
non particularitate corporis tantum, sed particularitate 
temporis quia raro medicus lucratur pecuniam cum 
eis. Et sunt litargia, mania, desipientia, melan- 

It is to be feared that Gaddesden was somewhat 

He has a long section upon the care of the health 
in general which is mainly an expansion of the 
Regimen Sanitatis. But his remarks on the use of 

1302 E 


fruit as a diet read oddly nowadays, and it is certain 
that he would have nothing to do with the modern 
' Fruitarian '. s 

On f. 1 18 verso, col. i, he says : 

* The accustomed way of life should be observed 
unless it is very bad, and then it should be altered 
gradually. Therefore a way of life conformable to 
the " naturals " should be observed. If it only differ 
a little it may continue to be observed, but if 
much, then as I have said before it must be altered 

Let him whose life is ill-regulated beware, for if 
it does not affect him in the present yet, as says 
Avicenna, it surely will in the future. And those 
who say that they eat often and to excess without 
any harm, let them have a care, for they will be 
struck down. Therefore should God punish at once 
whatever sin be committed, no man should live. 
And as with universal nature, which is God, so with 
particular nature in man, for punishment comes not 
at once, but in the course of time. 

Again with fruits ; some eat more of them than of 
other food, wherein they do not well, for all fruits 
make watery useless blood, and prone to putrefaction. 
But yet styptic fruits should be eaten after dinner by 
those who are inclined to looseness of the belly, and 
such are pears, figs {coctaiia), and apples. But these 
when roasted and taken by sufferers from the colic 
before dinner are laxative. When eaten raw, how- 
ever, they are constipating, though not all equally, 
for the sweet are less so and the sour more. Prunes, 
cherries, raisins, and figs should be taken before 
dinner, as Isaac lays down in his book on particular 
diet. But the common way of taking them is the 
opposite of this, and that is bad, for the fig, owing 
to its flatulent qualities, stops up (the bowels), and 


therefore ought to be eaten with ginger, for Avicenna 
notes that this drug is very opposed to all corruption 
of fruit. On the whole, however, it is best to do 
without fruit altogether, whence Galen in the sixth 
book of his regimen says that his father lived for 
one hundred years because he never ate fruit. 

Again, in animals fit for food, some prefer the tail 
and others the head, some the bones and some other 
parts ; whence the line " Pisces et uxores in cauda 
sunt meliores". 

It is also said that there is least waste product in 
the tail of a fish (" piscis est cum minori superfluitate 
in Cauda") because the tail is most in motion. Yet 
other parts are more easy of digestion, as is the 
case with the belly in salmon. That part, therefore, 
which is most in motion gives rise to least waste, 
wherefore that part in animals used for food is the 
best for man, ceteris paribus. That part, therefore, 
should be chosen, which is tender, is much in motion, 
and which tastes good, for ceteris paribus that part 
which tastes best nourishes best.' 

There is, it is obvious, much sound common sense 
in the above passage, and the tincture of theology — 
Gaddesden, it must be remembered, held a theological 
degree — together with the somewhat free allusion 
to women, is due to the cast of mind so common 
in mediaeval times, to which was due the curious 
indelicacy of many of the carvings on the misereres 
in cathedrals. Whether Gaddesden held Pantheistic 
views or not may be left to theologians to say, but 
possibly the words ' Sicut est de natura universal! 
quae est deus' might be taken to show such.' 

^ The words may only mean that he is conscious of the 

E 2 


It is possible that he may have been thinking of 
the following passage from Seneca, Naturales Quae- 
stiones, ii. 45 : 

' Ne hoc quidem crediderunt, Jovem, qualem in 
Capitolio et in caeteris aedibus colimus, mittere manu 
sua fulmina, sed eundem quem nos Jovem intelligunt ; 
rectorem custodemque universi, animum et spiritum 
mundi, operis hujus dominum et artificem, cui nomen 
omne convenit : vis ilium fatum vocare, non errabis : 
hie est ex quo suspensa sunt omnia, causa causarum : 
vis ilium providentiam dicere, recte dices : est enim 
cujus consilio huic mundo providetur, ut inoffensus 
exeat et actus suos explicet : vis ilium naturam 
vocare, non peccabis : hie est, ex quo nata sunt omnia, 
cujus spiritu vivimus : vis ilium vocare mundum, non 
falleris : ipse enim est hoc quod vides totum, partibus 
suis inditus, et se sustinens et sua.' 

The Naturales Quaestiones were much used in the 
Middle Ages as a textbook of physical science, al- 
though, as Mr. Mackail says, 'they are totally without 
any scientific value.' As regards * the naturals ' 
there were seven, and they will be found below in 
the translation of the Ysagoge, p. 137. 

The chapter following that on health in general 
deals with colic, a complaint which seems to have 
been common in the Middle Ages, and one doubtless 
due to the quantity of salt meat which was eaten, as 
well as to the habit of cooking meat with an enormous 
quantity of flavourings such as ambergris together 
with sugar and fruits. 

immanence of God, and might he not have been thinking of the 
Monologion of Anselm: 


He commences by saying that the disease is 
called colic, ' quasi colon capiens/ and his second 
definition, for two are given, is, colic is an affection 
{passio) of the last part of the intestine, which is 
called the colon, accompanied by a difficulty in the 
outgoings of the contents (substantia) through the 
lower gut, together with great pain which is some- 
times darting {pwicturd). There are seven causes 
of colic, and it is interesting to note that intestinal 
paralysis is apparently given as one of them. He 
gives them in verse as follows : 

' Sunt colicae causae septem sub carmine clausae, 
faex ignita, cibus constipans, flegmata grossa, 
ventus, apostema, vermes, destructio sensus.' 

Ignita is so written, but a few lines above he gives 
Faex dtcraia as a cause. 

He proceeds to discuss the difference between the 
iliac passion, the colic passion, and renal colic, and 
notes that the iliac passion was accompanied by 
frequent vomiting, by hardness of the belly, and by 
extremely acute pain as if a gimlet were boring 
through the intestine, and it would seem that under 
the names iliac or colic passion there were various 
forms of intestinal obstruction and possibly per- 
forative peritonitis included. The iliac variety is 
specially fatal. As for cure there are two indications, 
the one to soothe the pain and the other to remove 
the cause of the disease. For this last seven things 
are necessary, of which the third is to obtain complete 
evacuation of the bowels ; and here he quotes three 


cases from Galen to show, as that great physician 
remarks, * that the physician must not in these cases 
always go by contraries, but should weigh every 
case with intellect and judgement.' The last thing 
to be done in case other means fail is to try empirical 
remedies, and of these Gaddesden gives an enormous 
list, many of which are singularly nasty ; but it will 
be remembered that even in the last century 
Waterton was a firm believer in the merits of a cow- 
dung poultice. He concludes his remarks by saying 
that if colic arises from a rupture of the intestine it 
must be reduced. Afterwards a bandage must be 
applied, which is to be worn forty days if possible, 
the patient's bowels being kept open by suppositories. 
Gaddesden's logical training is shown by the way 
in which he divides up the causes of diseases, thus 
(f. 123 recto, col. i) ' the causes of stone are many, 
both material and efficient '.^ Again (f. 44 verso, col. 
2), ' Causae arteticae passionis sunt duplices interiores 
et exteriores,' or, sometimes they are called ' intrinsic 
and extrinsic'. 

To sum up, the Rosa Anglica may be taken to 
give us a very fair picture of an English physician 
of the fourteenth century. We see therein a man 
of good general education and, as regards his 
medical education, one who was acquainted with the 
writings of his predecessors. More than this, he 
must have been an accurate clinical observer. Of 

^ These were two of the Aristotelian four causes, the other 
two being formal and final. 


anatomy he naturally knew next to nothing, and 
of physiology even less. The book bears out the 
somewhat unfavourable estimate of the character 
of the leech which is expressed by Chaucer, by 
Langland through the mouth of Piers Ploughman, 
and by John of Salisbury, for Gaddesden appears 
to have been fond of his fees and by no means to 
have neglected the by-ways of medicine such as diet, 
cookery, and the care of the complexion or beautify- 
ing of the body. 

Gaddesden was, moreover, fully possessed of ideas 
as to the dignity of his office, not unmixed with the 
notion common to ' medicine men ' of all nations that 
medicine was in some way a mystery which should not 
be communicated to the uninitiated layman. He 
was evidently a man with a shrewd knowledge of 
the world and of the weaknesses of human nature, 
while his practice lay mainly among the upper 
classes ; but that he had poor patients is shown by 
the fact that he frequently gives an alternative pre- 
scription, ' if the patient be poor.' 

Considering the date of the book there is one 
rather curious omission. Although the Rosa is full 
of the beliefs and false pathology of the time, 
Gaddesden makes scarcely any mention of any 
astrological matters. In this he differs markedly 
from his notable contemporary John of Burgundy, 
who in his treatise De Pestilentia (Sloane MSS. 
3449) lays it down as a necessity that those who 
presume to treat the plague should be well grounded 


in the knowledge of the stars. But on the whole, 
despite the adverse judgements of Guy de Chauliac^ 
and of Haller some three hundred years later, it is 
fair to say that the Rosa Anglica contains much that 
is sound and much that is applicable to disease at 
the present day even in the light of our present 


The following is the passage from John of Burgundy's work 
upon plague m which he lays down the necessity for the physician 
having a knowledge of the stars : 


Extract from Sloane MS. 3449, f. 6 : 

' Also alle they whos complexion contrary to the aire that is 
chaunged or corupte abiden hole and elles alle folke shuld 
corupte and dye at onys. The aire therfore so corupt and 
chaunged bredith and engendreth in diverse sikenes and sores. 
After the variauncez or diversitees of theire humours for avery 
worcher or every thing that werchith performeth his werke after 
the abilite and disposicion of the matier that he werkith ynne. 
And by cause that ther have bene many grete maistirs and ferre 
lernyd in theoric or speculacion and groundly in sight of medecyne 
but they bene but litill proued in practik and therto allefully 
ignorant in the sience of Astronomy the whiche science is in 
phisik wonder nedefuU as wittenessith ypocras in epidimia sua 
seying what phisician that ever he be and kan not astronomy no 
wyse man owt to putte hym in his handis for why astronomye 
and phisik rectifien yche other in effect and also that one science 

' Guy's contemptuous note is as follows ; it appears in the 
preface to his Surgery which was completed 1363: 'Ultimo 
insurrexit una fatua Rosa Anglicana, quae mihi missa fuit et visa ; 
credidi in ea odorem suavitatis, et inveni fabulas Hispani, Gilberti 
et Theodorici.' 


sheweth forthe many thynges hidde in the other alle thynges in 
thyng may not be declared. And I 40 yere and more have oftyn 
tymes proved in practise that a medecyn gyven contrary to the 
constellacion all thogh hit were both wele compownyd or medled 
and ordynatly wroght after the science of phisik yit it wroght now- 
ther aftur the purpose of the worcher nor to the profite of the 
pacient. And when some men have gyven a medecyn laxatyf to 
purge downe ward the pacient hath casten it out ayene above all 
thogh he lothed it noght. Wherfore they that have not dronkyn 
of that swete drynke of Astronomye mowe putte to thise pestilen- 
tiall sores no perfite remedie for bicause that they knowe not the 
cause and the qualite of the sikenesse they may not hele it as 
seith the prynce of phisik Avicenna. How schuldest thou he 
saith hele a sore and thou knowe not the cause. 

iij canone capitulo de curis febrium. He that knowith nat the 
cause hit is onpossible that he hele the sikenes. The comentour 
also super sectmdum phisicorum seith thus A man knowith nat a 
thyng but if he knowe the cause both ferre and nygh. Sithen 
therfor the hevenly or firmamentall bodies bene of the first and 
primytif causes it is bihovefuU to have the knowlechyng of hem 
for yf the first and primytif causes be onknowen we may not come 
to know the causes secondary. Sithen therfor the first cause 
bryngeth in more plentevously his effecte than doth the cause 
secondary as hit shewith. primo de causis. Therfor it shewith 
wele that without Astronomye litill vayleth phisik for many man 
is perisshed in defawte of his councelour.' 

As has already been mentioned Gaddesden says practically 
nothing about a knowledge of the heavenly bodies being necessary 
for a physician. In one place he refers to the phase of the moon, 
and that is in the section on Sterility (fol. 10 1 verso, col. i) : 

'Ad 25m annum mulieribus plus veniunt menstrua in prima 
quadra lunae sed in senioribus veniunt in tertia vel quarta ipsius 
lunae. Et ideo puellis in prima quadra, juvenibus in secunda, 
senioribus post illud. Et ex hoc possumus scire quod juvenes 
debent flobotomari in nova luna et senes in antiqua et hoc senes 
a senectute ; quia senes a senio non debent flobotomari via 
electionis, unde dicitur — 

Luna vetus veteres, juvenes nova luna requirit.' 

N.B. — Senectus lasted from 60 to 80. Senium lasted from 80 
onwards (Joannes de Deo, Doctor Decretorum Bononiensis), 


Arderne, who was Gaddesden's contemporary, although junior 
to him, gives elaborate tables for finding the house of the Moon 
in relation to operations. The passage is on p. i6 et seq. of 
Mr. D'Arcy Power's edition, E.E.T.S., Orig. Series 139, 1910. 
John of Burgundy is a mysterious and interesting personality. It 
is possible that he andSir John Mandeville were the same person. 
Dr. Payne wrote to me in 1905 : ' he is not mentioned, so far as 
I know, in the continental Histories of Medicine, and nearly all 
the MSS. are in English libraries.' 

His treatise on the Pestilence, i.e. the Black Death of 1348, 
exists in many MSS., and there are numerous copies both in 
English and Latin in the British Museum and the Bodleian. He 
practised in Liege. 



Three copies. Ref., Class Catalogue, Medicine, vol. i, p 73 : 
Sloane 16 12, Sloane 1067, Sloane 280. 

Also, extracts from by Sir T. Browne, seventeenth century. 


Copie en 1356. 
II porte le no. 16643 dans le fonds des mss. Latins. 

There are four editions (printed) in the British Museum of 
Rosa Anglica by J. of Gaddesden. Press-marks : (i) 5309. dd. i. 

1492 ; (2) 543- g- 19- (2) 1502 ; (3) 7441- h. 16. 1517 ; (4) 542. 
a. 8. 9. 1595. 

There is an interesting tract by Dr. George Dock, of Ann 
Arbor, Michigan, on ' Printed Editions of the Rosa Anglica '. It 
was originally printed va Janus, xii^ annee, livraison viii, 1907. 


There are MSS. of the Rosa, and the Venice ed. of 1502 in the 
Bodleian, while Merton College possesses one ; — 

MS., No. 262 in Coxe's Catalogue and three printed copies : 
Pavia 1492, Venice 1502, Augsburg 1595. 


It must always be remembered that the mediaeval 
physician derived his knowledge almost entirely from 
books. Sometimes, as in the enlightened kingdom 
of Sicily in the thirteenth century, a post-graduate 
course of instruction under an experienced physician 
or surgeon was prescribed before the newly gra- 
duated man was allowed to practise ; and Mirfield, 
of whom Dr. Norman Moore has written, speaks of 
Magister metis ; but in general book-learning formed 
the whole of his knowledge until the physician had 
been in practice for some time. Patients seem to 
have been aware of this, for Arnold de Villanova in 
his ' Cautels for medical men ' ^ says : ' When you 
come into the patient's presence always do something 
new, lest they should say that you can do nothing 
without your books.' Hospitals other than leper 
hospitals w^ere few and far between, and when they 
did exist were in no way places for medical teaching. 
The sick were ' cared for ', but there was no pro- 
vision for medical attendance. 

Moreover, the mediaeval patient seems to have 
been in no way averse from trying to take in his 

^ Opera omnia, Basileae, 1585, col. 1454. 


medical attendant, and the 'Cautels' above-mentioned, 
which are attributed to Arnold de Villanova who was 
born in the latter half of the thirteenth century, give 
an amusing picture of the possible relations between 
patient and physician. They commence by an 
account of the pitfalls into which a physician might 
fall during the inspection of the urine, this inspection 
being the chief method of diagnosis, a method which 
prevailed well into the seventeenth century. Not 
only was the physician supposed to be able to tell by 
this inspection the disease from which the patient 
was suffering, but also the sex and the age, and 
whether the urine was that of a human being or an 
animal. In a curious little work called The Key to 
Unknown Knowledge, or A Shop of Fine Windowes, 
printed so late as 1599, are contained five treatises, 
of which the first is entitled ' The Judgement of 
Urines ', The author withholds his name, but says 
in his preface that he has gathered together rules 
concerningthe judgement of urine from divers authors 
for the benefit of his fellow Chirurgians ' which have 
not the Latine tongue '. 

His fifth chapter gives the rules to know a beast's 
water from a man's, or from a woman's, and also the 
urine of a man from that of a woman. They are as 
follows : 

* First it is meet that you know as I have afore said 
that a man's urine the neerer that you hold it to the 
eye, the thicker it does shew : and when you hold it 
further off, it appeareth more thin, and the further 


the thinner and clearer it sheweth. But in beasts 
urine it is not so, for the more nie the eye the thin- 
ner and the further from the eye the thicker and 
more grosse : and this is {sic) shall not fail you.^ 

Also beasts water is more salt and of a stronger 
sauor, and more simple of complexion, and smelleth 
more raw, than the urine of a man. Also mix the 
water of a beast and wine together and they will 
depart each of them from the other. If it bee 
a cowes water which is with calfe, it shall be easie 
for you to know it from a womans urine that is with 
child ; for the dregs and the contentes shall be more 
grosse than the womans, and more foule for so much 
as the beast is of a fouler complexion. To know 
a mans urine from a womans understand that a mans 
in the casting does shew troublednesse in the middest 
of the urine : but you must note that in a womans it 
doth not so. 

And 2StQr Avicenna the froth of the urine of a man 
after casting is long ; and in the urine of a woman 
after casting it will be round.' ^ 

Various conclusions were also drawn from the 
pellicle which formed on the surface, and from the 
' circle ' or layer of the urine which lay immediately 
under the ' spume '. Then the urine as it stood 
in the urinal was divided into regions, in each of 
which appearances were seen which would guide 
the practitioner. But however much 'Avicenna' 
and the older physicians believed in these appear- 
ances, Arnold was quite aware that most of them 

^ Cf. Avicenna, Canon, Bk. I, Fen. 2, Cap. 10, Theophilus, 
Lib. Urinar. 

2 The Collectio Sakrnitana, edited by S. de Renzi, contains 
numerous tractates on diagnosis by inspection of the urine. 


were, to put it shortly, humbug, as will be seen from 
the following : 

' Videndae sunt cautelae circa urinas quibus pos- 
sumus nos cavere a deceptoribus.' 

Firstly, the practitioner had to make certain that 
the fluid brought to him for inspection was that of 
a man. It might be of some other animal, or even 
not urine at all ; but the urine of the man could be 
recognized in four different ways. 

Then the messenger bringing the urine must be 
fixedly looked at, ' tu enim debes ipsum fortissime 
respicere et renere ^ oculos fixos supra ipsum.' 
Under this close scrutiny the fraudulent messenger 
would either laugh or else change colour ' cui debes 
dare maledictionem perpetuam et aeternam ', It 
seems a heavy punishment for a comparatively harm- 
less deception, but evidently mediaeval physicians 
had a full share of proper pride. 

As for the sex of the patient it was ascertained as 
follows : 

* The fourth caution is concerninof the sex. The 
old woman will ask you to tell her, and then you must 
ask her from whom the urine is (" tu inquire cujus 
est"), then she will say " Don't you know ?" Then 
you must look at her with a sidelongglance ("quodam- 
modo oculo distorto") and say, "What business is 
it of yours ? " Then if she is not very sly she will 
say, " It is Jack's or Jill's " ("dicit quod est cognatus 
vel cognata "), or something by which you may 

^ Sic, but probably a misprint for tenere. 


ascertain the sex. If, however, she says, " Oh it 
doesn't matter to me," ask what the patient gener- 
ally does when he is well, and so you will be able to 
tell or at all events make a very good guess at the 

Other cautions follow, and then comes no. 7 
which runs : 

' The seventh is this, and it is perhaps one of 
very general application. Very possibly you gather 
nothing at all from an inspection of the urine ; very 
well then, say that the patient is suffering from 
obstruction of the liver. Your visitor (i.e. the person 
who has brought the urine) will say, " No, Sir, it 's his 
head or his legs or somewhere else " ; then you must 
say ; "Well that comes from the liver or the stomach." 
Be sure to use the word " obstruction ", for they don't 
understand it, and it is often exceedingly useful that 
people should not understand what you say.' 

Other cautions warn the young practitioner from 
being taken in by wine, or liquors made from figs or 
nettles, which are often substituted for urine. Caution 
13 runs as follows : * If the old woman asks what 
is the matter with the patient, say, " You would not 
understand if I were to tell you, and it would be 
much better if you were to ask, What am I to do for 
him ? " 

* Then she will see that you are right, and will hold 
her tongue. Possibly, however, she will say, " Sir, 
he is so hot that I think he has fever " ; whereupon 
you answer, " That is always the way with you and 
other people who don't know the difference between 
fever and other diseases." ' 


Other cautions are concerned with the behaviour 
and * bedside manner ' of the physician ; thus the 
sixteenth caution runs, ' When you come into the 
presence of the patient always do something new, 
lest they should say you can do nothing without 
your books.' And caution 17 : ' If by ill luck you 
should find the patient dead when you arrive at the 
house and they say, " Sir, why have you come? " you 
must reply that you did not come because he was 
dead, for you knew very well that he would die in 
the night, but you wished to know the exact hour at 
which he died.' 

After these worldly regulations it is somewhat sur- 
prising to find the following peroration, of which the 
following is a translation which but feebly reproduces 
the rhythmic cadences of the Latin. 

' Mark that the leech shall be earnest in inquiry ;' 
careful and methodical in discourse ; cautious and 
far-seeing in reply ; guarded in prognosis ; neither 
let him promise more than he can perform, and 
especially recovery. For then shall he thrust out 
God's work and do Him injury. But that he him- 
self will be faithful and diligent, he may promise. 

And he shall be discreet in his visits, painstaking 
in his talk, quiet in his ways, and kindly to the 

The writer of these Cautelae, whether he was 
Arnold or no, simply developed them from a tract 
by an unknown writer (? Archimathaeus) which is 
entitled ' De adventu medici ad aegrotum ', and which 


is contained in the Collcctio Salemitana} This 
commences as follows : 

' Cum igitur, o medice, ad aegrotum vocaberis, 
adjutorium sit in nomine Domini angelus qui 
comitatus est Tobiam ; affectum mentis et egressum 
corporis comitetur.' 

The meaning of this is obvious, but Arnold or his 
editor puts the passage thus, which makes it hope- 
lessly obscure : 

' Medice, cum ad aegrotum vocaberis, adjutorium 
sit in nomine Domini angelus qui comitatus est 
effectum mentis et egressus corporis concomitetur 

Another similar tract is given by Renzi,- and in 
both the Salernitan tracts and in Arnold appear 
instructions as to how the medical man should behave 
when asked to dinner, together with a warning that 
he should not make love to the patient's wife or 
daughter, or maidservant. 

It is interesting to compare the directions of our 
English surgeon, John of Arderne (_/?. 1360), con- 
cerning the manners of the leech with those given 
in the Cautelae. They were written in Latin and 
were translated into English in the fifteenth century 
(Sloane MS. No. 6).^ 

^ Salvatore di Renzi, Naples, 1859. Collect. Salem., tom. ii, 

P- 75- 

^ Colled. Salem., tom. v, p. 333. 

' The latest edition is that by Mr. D'Arcy Power, edited for the 

Early English Text Society, Original Series No. 139, London, 

Kegan Paul, Trench, Triibner & Co., Ld., and Henry Frowde, 

1302 F 


The Salernitan advises the leech to learn as much 
as he can from the messenger about the patient, 'ut 
quando ad ipsum accessieris, aegritudinis ejus non 
omnino inscius videaris ; ubi post visam urinam, con- 
siderato pulsu licet per eam aegritudinem non cogiio- 
veris, tamen si sinthoma quod praescriveras dixeris, 
confidet in te, tanquam in autore suae salutis, ad 
quod summopere laborandum est' This excerpt 
shows somewhat the same spirit as Arnold's Cautelae, 
but the point is not so frankly put. 

Fees in the Middle Ages were no more rapidly 
paid than now, and there are many passages in the 
Salernitan collection pointing out that the leech 
should press for his fee, or at least for an agreement 
to pay it, as soon as the patient was getting better ; 
for ' Mox fugit a mente medicus morbo recedente '. 

The following passage shows that our ancestors 
in the profession were quite awake to the necessity 
for getting their fees paid while the sufferings of the 
patient were still a vivid memory. They are from 
a version of the Regimen Sanitatis dedicated to 

Oxford University Press, 19 lo. The passage in question will be 
found on p. 6 et seq. Very similar rules for conduct are laid 
down by Henry of Mondeville, circa 1320; William de Saliceto, 
circa 1275; and Lanfranc, circa 1295, Mr. Power quotes from 
the two former in his ' Forewords ' to Arderne, while Lanfranc 
has been published in an English translation by the E.E.T.S., 
Orig. Series No. 102. Gaddesden does not mention this subject, 
neither does he lay stress upon the necessity for the leech to get 
his fee before the patient is well. In several places, however, he 
insists that the composition of medicine and methods of cure 
should not be revealed to the laity except for a due recompense. 


Charlemagne who conquered {szc) the Saracens at 
Roncesvalle. The heading is : 

De Prudentia Medici sumentis pro Labore. 

Non didici gratis, nee sagax Musa Hippocratis 

Aegris in stratis serviet absque datis. 

Sunipta solet care muhum medicina juvare 

Si qua datur gratis nil habet utilitatis. 

Res dare pro rebus, pro verbis verba solemus. 

Pro vanis verbis montanis utimur herbis. 

Pro caris rebus, pigmentis et speciebus. 

Est medicinalis medicis data regula talis 

Ut dicant ' da, da,' dum profert languidus, ' ha, ha.' 

Da medicis primo medium, medio, nihil imo. 

Dlim dolet infirmus medicus sit pignore firmus. 

Instanter quaere nummos, ut pignus habere. 

Foedus et antiquum conservat pignus amicum, 

Nam si post quaeris, quaerens semper eris. 

From this passage it is evident that the mediaeval 
patient, like his modern successor, was not satisfied 
without being ' given something to take ', for, says 
the writer, ' We are wont to give something in return 
for money, but for words we give only words,' 
a remark which he expands lower down into ' for 
words (i. e. verbal thanks) we give cheap medicines, 
but for a high fee we give rare and valuable 
medicines '. 

As an example of the way in which a rich patient 
was treated it is worth quoting from a poem by Gilles 
de Corbeil, a noted physician who lived from 11 40 to 
about 1220 and was physician to Philip Augustus.^ 

^ A short account of him will be found in Croke's book on the 
Regimen Sanitatis Salerniianum, Oxford, D. A. Talboys, 1830. 

F 2 


They are from Book II, 1. 68, a poem entitled 
' Liber de Virtutibus et Laudibus Compositorum 

Si toecunda magis si rerum plena facultas, 
Larga manus, praegnans loculus, si splendeat auro 
Area, vel argento niteat, domus ampla clientum 
Ferveat obsequio, si deliciosa potentis 
Plus aequo lasciva fames spoliare laboret 
Divitiis elementa suis, si purpura corpus 
Ambiat, aestivum digitis si fulguret aurum, 
Electum gemmata merum si vasa propinent, 
Si magnis se divitiis mens magna coaptet, 
Aggravet hie medicina manum ; sumptus onerosos 
Exigat ; hie positos debet transcendere fines. 
Contundat gemmas molat aurum misceat ambram, 
Balsama non dubitet propriis apponere causis, 
Lignum aloes fervente mero desudet et illi 
Se perdendo suum tribuat mandetque vigorem. 
Jacturam redimit opulentia, cura salutis, 
Hoc quoque, quod proprie geritur custodia vitae. 

This may be broadly rendered : 

' If the patient be a wealthy man in a high position, 
fond of display, and one whose life is spent in ac- 
cordance with his possessions ; if, moreover, his heart 
is as large as his purse, then the medical man should 
come down with a heavy hand. Large fees should 
be demanded, for in a case of this kind the ordinary 
boundaries may be overstepped. For the medicine 
let gems and gold be ground up, let amber and the 
balsams appropriate to the case be added together 
with a decoction of aloes in wine. The wealth of 
the patient justifies the expense, as does his anxiety 

' Quoted by C. Vieillard in his Gilles de Corbeil from Choulant's 
edition of the poem. The remainder of the quotations are from 
Leyser, Hist. Poetar. et Foe mat. Med. Aev, Halae, 1741. 


about his health, and the fact that the protection 
of his hfe is a matter of personal interest.' 

Like his successor Gaddesden, however, Gilles de 
Corbeil is by no means unmindful of the poor man, 
whom he apostrophizes as Codrus (Book II, 1. 91). 
Gilles had evidently read his Juvenal and Persius : 

Quid faciet Codrus ? Quid Codri curta supellex ? 
Cujus plebeia vacuus farragine venter 
Non satis impletur, spasmum patiente crumena 
Cujus opes modicis depicta sophismata cartis. 

' But,' he continues, ' because you cannot afford 
such luxuries as the above in the way of medicine, 
is that any reason why your health should 
suffer ? By no means ; simple poverty possesses 
a medicine which can be bought for three farthings. 
Beans, a little fat, a cabbage and bread made from 
" Offals", when taken into the hungry stomach, purges 
all grossness from the body. Food flavoured by 
hunger is that which is best assimilated. What is 
a more certain cure of disease, what a better medicine, 
than the simple life, and that befitting a lowly 
establishment ? Pure water and a humble way of 
life brings greater strength and longer life than the 
palace of Caesar or Falernian wine, or hunted game, 
or salmon, tunny, and the pink-fleshed trout ; eaten 
at the feasts of kings, such things become a weariness 
to the flesh.' 

Excellent advice, no doubt ; but Codrus, like the 
patient of to-day, sometimes demanded more. He 
wanted 'a bottle'. Hence in another passage 
(Book II, line 725) Gilles describes a medicine called 
Diacostum, which was given both internally and 
externally for a splenetic tumour, without fever 


arising from black gall. He then goes on to describe 
a poor man who sees himself utterly unable to afford 
this remedy, and who therefore abuses his physician, 
saying that he holds himself up as the craftsman and 
overseer of health, goes about covered with rings, 
and cares for no one but his rich patients : 

Ars tua divitibus solis, quibus ampla facultas 
Quos vanos trahit in sumptus opulentia rerum, 
Servit et optatae praebet solatia vitae. 

When he talks of musk and balsam and other 
expensive drugs he is talking for Emperors alone, 
who care for nothing unless it Is expensive, but the 
poor are shut out altogether, ' Sterilesque excludls 

After having listened to this complaint Gilles 
turns on the poor man, setting the key of his rebuke 
by his opening words, ' Stulte, quid exacuis vanis tua 
verba querelis ? ' He adds that what can't be cured 
must be endured ; that it is no good to kick against 
the pricks ; that envy is both judge and executioner, 
with a number of other aphorisms all very appropriate, 
if scarcely satisfying. A poor man must be content 
with his lot, and should remember that the forest 
offers him plenty of materials for restoring his health 
without anything to pay. 

All this, however, is mere pose, for in the final 
section of the poem, which he oddly calls ' Prologus 
finalls ', he gives the following admirable advice to 
young men and boys whom * The delphic Inspiration 
incited to the art of the physician'. They are not 


to be impelled by greed, but kindliness alone, and 
divine love should urge them to give their service 
to the poor (Book IV, 1. 1466 et seq.). There is 
no shame in a poor physician taking proper rewards 
for his skill, just as Horace took rewards from 
Maecenas. He continues (line 1481) : 

At si dives eris, si magnis rebus abundans, 
Aegris pauperibus et munimenta medendi 
Largius impendas, ut subsidiaria vitae 
Dona pluas miseris, quo justior est medicinae 
Fructus et uberior ; nulla ratione recuses 
Quae tibi nobilium (donat) praelarga virorum 
Munera nobilitas ; sua namque repletio solvi 
Debet, ut ariditas foveatur pauperis aegri. 
Interdum minuendus erit pro paupere dives. 

There is a word missing in line i486. The sense 
obviously requires a word like ' gives ', so I have 
supplied donat. It will be noted that the idea of 
bleeding the rich for the poor is not peculiar to 
modern Budo^ets. Gilles concludes his work with 
the old advice that patients pay more readily while 
they are still in pain. With patients of the very 
highest class (line 1494) no agreement for payment 
need be made beforehand ; if the patient is generous 
he will pay generously, and if he is mean, then the 
very fact of having attended a great prince will pay 
the physician in renown and advertisement. Second- 
class persons, however, ' homines classique secundae 
Addictos,' should be strictly bound down to pay, 
' Firmis vincire memento Pactorum laqueis.' 


Mediaeval Quacks 

The quack and the amateur practitioner were 
much the same in the Middle Ages as they are now, 
as is shown by the following verses from the Flos 
Medicinae : 

Fingit se Medicum quivis idiota, prophanus 
Judaeus, monachus, histrio, rasor, anus, 
Sic[uti] Alchemista Medicus fit aut Saponista 
Aut balneator, falsarius aut oculista 
Hie dum lucra quaerit virtus in arte perit. 

The quack or the idiota of the Middle Ages was 
in every way similar to his brother of the present 
day, with the sole exception that he did not pretend 
to use electricity or magnetism, for the very good 
reason that these forms of energy were practically 
unknown. Even the * patter ' was the same, as 
shown by the following passage from Rutebeuf : ^ 

* Good people ! I am not one of the poor preachers, 
nor one of those poor herbalists who go in front of 
the churches with their shabby ill-sewn cloaks, who 
carry boxes and bags and spread out (their wares) 
on a carpet, for they sell pepper and cumin and 
other spices. 

' Know that I am not one of them, I belong to 
a lady whose name is Trote (i.e. Trotula) of Salerno, 
who makes a kerchief of her ears and whose eyebrows 
hang down as chains of silver behind her shoulders ; 
and know that she is the wisest lady in all the four 

^ Flos Afedicinae, pars x, civ. 

^ Diz de Verberie : CEtwres completes de Rutebeuf , Jubinal's ed. 
1874, vol. ii, p. 58. Rutebeuf was a trouvere of the thirteenth 


quarters of the world. And my lady sends us out 
into many divers lands and countries, into Apulia 
and Calabria and Tuscany and the Terre de Labour, 
and Germany and Soissoins and Gascony, Spain, 
Brie, Champagne, Burgundy, and the Forest of 
Ardennes, to kill wild beasts and extract ointments 
from them to give medicines to those who are bodily 
ill. My lady charged me strictly that into whatever 
place I should come I should say nothing but what 
would set a good example to my hearers, and because 
she made me swear by the Saints before I left, 
I will now learn you the cure for worms if you will 
hear me. Will you hear me ? 

* Is no gentleman here going to ask from what 
worms come ? I will tell you. They come from 
cooked up meats and from wines in casks or bottle, 
so they grow in the body by heat and humours, for 
so say the philosophers all things are created, and 
they mount towards the heart, and then you die of 
a malady which is called sudden death. Mark you 
this well, and God guard you. 

* And for the cure the best herb in all the world is 
ermoize. ... In Champagne, where I was born, they 
call it Marreborc, which is as much as to say the 
mother of the herbs. Take three roots of this, five 
leaves of sage, three leaves of plantain, beat them in 
a brass mortar with an iron pestel, and drink the 
juice for three mornings running the first thing in 
the morning and you will be cured of your worms. 

' Take off your hats, lend me your ears, and look 
at the herbs which my lady sends into this land and 
country ; and because she wishes that the poor 
should be as well in the future as the rich, she told 
me to make pennyworths of them, for many a one 
has a penny in his purse who has not ^5, and she 
said that I might take pennies of the money current 
in any land whither I may come, a Paris penny in 


Paris, an Orleans penny in Orleans, a Chartres 
penny in Chartres, and a penny sterling in London 
which is in England, for good bread and wine for 
myself and for good hay and oats for my pack horse, 
and for anything else I may want to live. And if 
there be any here who is so poor or so lonely or 
hungry that he has nothing to give, let him come 
forward and I will give him one hand for the sake 
of God and the other for the sake of His mother. . . . 

' These herbs, you will not eat them, for there is 
no ox nor no war horse, be they never so strong, 
but if they had a piece of these herbs on their 
tongues as big as a pea would presently die an evil 
death, for they are so strong and bitter, but what is 
bitter in the mouth comforteth the heart. Steep them 
three days in good white wine ; if you have no white 
take red, if you have no red take brown, if you have 
no brown take fair clear water, for many a man has 
a well before his door who has not a cask of wine in 
his cellar. 

* Take it the first thing in the morning for thirteen 
mornings ; if you miss one take another, for there is 
no mystery about them ; and I tell you by the passion 
of God that you will be cured from all disorders and 
disease, from quartan fevers, from gout. . . . And if 
my father and mother were in peril of death and 
were to ask me for the best herb I could give them 
I should give them these. This is how I sell my 
herbs and ointments ; if you want them come and 
take them, if you don't want to, let them alone.' 

It must be remembered that in some instances the 
quack's remedy was less nauseous and yet quite as 
efficacious as those of the orthodox practitioner. 
Take the following prescription from Gaddesden for 
the stone [Rosa Aug., fol. 124 verso, col. i) : 


' Habui unum calculosum quern per longum tempus 
non potui sanare, tandem leci colligi scarabaeos 
multos qui inveniuntur in stercoribus bourn in 
aestate et cicadas quae cantant in campis et ablatis 
capitibus et alls de cicadis, posui illas cum scarabaeis 
in oleo communi in olla : tunc obturata olla posui banc 
in forno in quo fuit tarde panis et dimisi ibi per 
diem et noctem : et extracta tunc olla ad ignem 
calefeci modicum et totum simul contrivi, et renes et 
pectinem inunxi et intra triduum cessavit dolor et 
lapis comminutus et fractus exivit.' 

He also gave the patient ' fisticadary et fisticos 
sicut si esset panis '.^ It is sad to say that so far 
as the crickets go this prescription is a shameless 
plagiarism from Arnold de Villanova.^ 

But in spite of their extraordinary remedies 
Gaddesden and other educated leeches of the time 
had at least studied medicine, in so far as any study 
was possible ; they had read such books on the 
subject as were available, and we may believe that 
in general they would try to act up to the admirable 
advice contained in Arnold Villanova's works com- 
mencing ' Mark that the leech ', which was quoted 
above. There was no General Medical Council or 
Medical Register in those days, but instead the law 
did protect practitioners who had obtained a medical 
degree or a licence to practise, and severe measures 
were meted out to the quack; for instance, in 1381 
one Roger Clerk was attached before the Lord 

* Fistici are pistachio nuts. 

^ Ed. Basil, Op. Omniay 1585, p. 1269 D. 


Mayor for pretending to be a physician and for 
having asserted that he could cure a woman. The 
cure consisted in making her wear a parchment with 
the well-known adjuration Anima Christi written 
therein. The woman did not get any better, and to 
the end that the people might not be deceived he 
was led through the City on a horse without a saddle, 
the said parchment round his neck and a urinal hung 
in front and another behind.^ 

The Popular View of the Medical Man. 

It is plain, however, that the popular estimate of 
the ' qualified ' leech in mediaeval times was by no 
means flattering, although the profession is not 
scoffed at in the same way as are the regular clergy, 
the friars, and occasionally the parish priests. These 
last, in England at any rate, seem to have won the 
affection of the populace, although a different story 
is told in Germany and Italy.^ Some seven hundred 
years before the time of Gaddesden, namely in the 
year 600 a. d,, Isidorus Hispalensis, who was Bishop 
of Seville, wrote a work called Liber EtymologiariLm, 
which was an encyclopaedia of the knowledge of his 
time, and it naturally contained a chapter on medicine. 
In Book IV, cap. 4, of the edition printed in Venice 
in 1483 by P. Loslein, fol. 20 recto, col. i, there is 
the following passage : 

' H. Riley, Memorials of London, p. 466. 

- See Tyll Eulenspiegel, the Decatneron, and Reynard the Fox. 


' Hi itaque tres viri totidem hereses invenerunt. 
Prima metodica inventa est ab Apolline, quae 
remedia sectatur et carmina. Secunda empirica, 
id est experientissima, inventa est ab Aesculapio, 
quae non indiciorum signis, sed solis constat 
experimentis. Tertia logica, id est rationalis, 
inventa ab Hippocrate. Iste enim discussis 
aetatum, regionum, vel aegritudinum qualitati- 
bus, artis curam rationabiliter perscrutatus est. 
Empirici enim experientiam solam sectantur ; logici 
experientiae rationem adjungunt ; metodici nee 
elementorum rationem observant, nee tempora, nee 
aetates, nee eausas, sed solas morborum substantias.' 

In view of the connexion of Hippocrates with 
' logical and rational ' practice, it is noteworthy that 
in the two great mediaeval medical schools of Salerno 
and Montpellier, Hippocrates and Galen were the 
two authors whose works were especially studied. 
Salerno, indeed, was called Ci vitas Hippocratica ; 
Montpellier, though commending the study of Hippo- 
crates, seems to have held Galen in the greater 

Isidore in cap. 13 of the same book lays down 
what was considered necessary for a physician of his 
day to know. 

' It is sometimes asked why the art of medicine is 
not included among the other liberal arts. It is 
because they deal with single causes, but medicine 
with all. For a medical man should know the ars 
graimnatica, that he may be able to understand and 
expound that which he reads ; and the ars rhetorica, 
that he may be able to support with sound arguments 
the matters which he deals with ; and also the ars 


dialectica, so that by the exercise of reason he may 
investigate the causes of sickness for the purposes of 
cure. So too he should know the ars arithmetica, 
so as to calculate the times of the accession (of fever) 
and its periods ; and he should be acquainted with 
the ars geometrica, so that he may teach what every 
man ought to consider with regard to different 
districts and the lie of different places ( " qualitates 
regionum et locorum situs"). Moreover, he must 
know something of music, for many things can be 
done for the sick by means of this art, as we read 
that David delivered Saul from the evil spirit by 
means of music. Asclepiades restored a madman to 
his former health by means of a concord of sounds 
{symphonia). Lastly, let him have a knowledge of 
astronomy by means of which he may understand 
the calculation of the stars and the changes of the 
seasons. For as a physician says, our bodies are 
affected {comnmtaiitur) by their qualities, and there- 
fore medicine is called a second philosophy ; for either 
art arrogates to itself the whole man, since by the 
one the soul and by the other the body is cured.' 

Nearly six hundred years later John of Salisbury, 
one of the leaders of mediaeval thought, who was 
born 1115-1120, who studied in France and was 
acquainted with Montpellier, wrote about the year 
1 1 59 a treatise called Polycraticus, sive de nugis 
Curialium et Vestigiis Philosophoruni} A chapter 
of this is well worth study on account of the views 
therein expressed of the medical profession as it 
appeared to a leading philosopher of the day. In 
the previous chapter he had written against those 
who consulted diviners and magicians, and the 29th 

' Migne, Patrol, Lat, vol. cxcix. 


chapter opens as follows ^ : — Physicians by this time 
were divided into theorici and praciici. 

' And yet it is lawful for some one to be consulted 
about the future, as for instance in the case of any 
one who is full of the spirit of prophecy, or from the 
teachings of Medicine has learned the natural signs 
that may be expected to occur in animal bodies, 
or has drawn differences from past experience as 
to the conditions which will exist in the immediate 
future. To the latter, however, let no one lend 
an ear in so far as they may impugn either faith or 

' Neither are the former to be listened to except in 
so far as what they say is of the Lord and is in no 
way contrary to religion, for truth cannot be contrary 
to truth nor good to good. But the physicians, while 
they attribute too much authority to Nature, cast 
aside the Author of Nature, withstanding the faith. 

' Not that I would charge them all with errors, 
although I have heard many of them disputing 
otherwise than faith would have it about the soul, its 
energies and working, about the growth and decline 
of the body, about its resurrection, and about the 
creation of bodies both natural and spiritual. 
Sometimes they talk about God Himself 

" As if earth-born giants were to attempt the stars," 
and by their empty toil appear to be anxious to 
deserve the fate of Enceladus and to have placed 
upon them the fiery burden of Etna. ^^ 

' In matters of this kind, however, it is easy to fall 
away, for however great be the natural parts, they 
are brought to a stand upon this side of the abyss of 
difficulty which is found in supernatural affairs. 

^ Joannes Sarisburiensis, Polycraticus, ed. Migne, cap. xxix, 
col. 475. loannis Saresberiensis, /<?//^r«//^?/j : ed. C. C. J. Webb, 
vol. i, p. 166. Clarendon Press, 1909. 


Where, then, the Intellect fails, and the reasoning of 
faith is absent, that mental process which lies between 
the two, namely conjecture, alone remains. But 
when the matter under discussion is of an inferior 
nature, take for instance the physical constitution 
of the animal body, or the cause and cure of sickness, 
nothing is wanting to them, except the accomplish- 
ment of their work, if indeed that is what they desire. 

' The theoretical physicians do what concerns them, 
and for love of you will even go further. You can 
get from them information as to the nature and causes 
of particular phenomena, they are judges of health, 
of sickness, and of the mean state. Health, so far 
as words go, they provide and preserve, and as 
concerning the mean state they bid one incline in the 
direction of health. Of sickness they foresee and 
declare the causes, and lay down its beginning, its 
continuance, and its decline. What more shall I say ? 
When I hear them talk I fancy that they can raise 
the dead and are in no way inferior to either 
Aesculapius or Mercury. 

' And yet with all my admiration I am much 
troubled at one matter, and that is they are so 
singularly at variance in their discussions and in the 
opinions which are drawn from them. For this one 
thing I do know, that contraries cannot both be true 
at the same time. 

' Again, what shall I say about the practising 
physicians ? 

' God forbid that I should say anything bad about 
them ! since for my sins I fall only too often into their 
hands. They should rather be soothed by politeness 
than angered by words, and I do not wish that they 
should treat me hardly, nor could I endure all the 
evils about which they constantly talk. I would 
rather say with blessed Solomon, ' All medicine is 
from the Lord, and he that is wise will not despise it.' 


* Nor is any one more useful or more necessary than 
the physician so that he be faithful and full of 
foresight. For who can say enough in his praise 
who is the craftsman of health and the begetter of 
life in that he takes after the Lord and stands in his 
place, for that health which the Lord gives as a 
Prince, the physician, as steward and minister, 
administrates and dispenses. 

' It is of little moment if some physicians sell an 
imaginary benefit, and that they may appear the 
more honest take no fee before the patient is 
well. But such are dishonest in that they give 
themselves the credit for a recovery which is due to 
time, or rather to the gift of God ; for it is due to 
God and to the natural powers of his constitution 
that the sick man is raised up. Few are they who 
act in this way, for you will always hear physicians 
advising one another as follows : — " take your fee 
while the patient still feels ill." 

' Personally I do not care much if their actions and 
advice are in opposition, for I know that contraries 
often produce the same effect. But if a patient of 
theirs should come near death they will put forward 
the most cogent reasons for showing that his life 
should be no more prolonged. And, too, it is said 
that for those w^hom they have broken down by long 
fasting and who are at the point of death they will 
provide absolutely useless broths and delicate meats. 
Perhaps you look for me to say, what the common 
people say, that physicians are the class of men who 
kill other men in the most polite and courteous 
manner. Well, you will be disappointed ; God forbid 
that I should do them this injury! But if you want 
to hear them talked of in such a style I refer you to 
Seneca, to Pliny, and to Sidonius Apollinaris, who 
will fill your ears with discourses much to the point.' 

The passage of Sidonius to which John of Salisbury 



refers is as follows. It occurs in his letters, Bk. ii, 
letter xii, addressed to Agricola. 

' Igitur ardori civitatis atque torpori, tarn nos quam 
domum totam, praevio Christo, pariter eximimus, 
simulque medicorum consilia vitamus assidentum 
dissidentumque, qui parum docti et satis seduli 
languidos multos officiosissime occidunt. Sane 
contubernio nostro jure amicitiae Justus adhibebitur, 
quern, si jocari iibet in tristibus, facile convincerem 
Chironica magis institutum arte quam Machaonica ; 
quo diligentius postulandus est Christus obsecrandus- 
que ut valetudini, cujus curationem cura nostra non 
invenit, potentia superna medeatur.' 

The subject of the letter is the health of his 
daughterSeveriana,and he excuses himself from going 
fishing with Agricola on account of her illness 
because they are going to the country. 

' Therefore,' he continues, * we and our household, 
Christ being our leader, have left the heat and 
weariness of the City, and at the same time the 
opinions of the physicians, who attend us and con- 
tend with each other. For they have but little 
learning, and although they are assiduous in atten- 
tion kill a large number of sick people in a most 
dutiful manner. But as a matter of friendship 
Justus (the physician) has joined our company, who, 
if I may joke at such a sad time, is, I would say, more 
skilled in the art of Chiron than in that of Machaon. 
And therefore Christ is to be most earnestly besought, 

^ ' Chironica magis quam Machaonica.' Messrs. J. F. Gregoire 
and F. Z. Collombet in their edition of Sidonius (Lyons and 
Paris, 1836) point out that by his remark Sidonius did not mean 
to depreciate Chiron's skill, but merely to pun upon the double 
meaning of x^ptav as a name and x^ipiav meaning ' worse '. 


that the divine power may restore that health which 
our care has been unable to bring about.' 

As to Pliny, the passages referred to are evidently 
the opening chapters of Book xxix of the Historia 
Naturalis. They seem to have been a loc2is 
classicus, as to the idea held by laymen about 
medical men in the Middle Ages, for they were 
quoted by Petrarch in the excerpts given below. 

The Seneca passage is to be found in the De 
Be7ieficiis, vi- 36 : 

* Gravissima infamia est medici opus quaerere. 
Multi quos auxerant morbos et inritaverant, ut 
majore gloria sanarent, non potuerunt discutere aut 
cum magna miserorum vexatione vicerunt.' 

The well-known lines of Chaucer concerning the 
Doctor of Physic must be quoted : 

With us ther was a Doctour of Phisyk, 

In al this world ne was ther noon him lyk 

To speke of phisik and of surgerye; 

For he was grounded in astronomye. 

He kepte his pacient a ful greet del 

In houres, by his magik naturel. 

Wei coude he fortunen the ascendent 

Of his images for his pacient. 

He knew the cause of everich maladye, 

Were it of hoot or cold, or moiste, or drye, 

And where engendred, and of what humour; 

He was a verrey parfit practisour. 

The cause y-knowe, and of his harm the rote, 

Anon he yaf the seke man his bote. 

Full redy had he his apothecaries. 

To send him drogges and his letuaries, 

G 2 



For ech of hem made other for to winne ; 
His frendschipe was nat newe to beginne. 
Wei knew he the olde Esculapius, 
And Deiscorides, and eek Rufus, 
Old Ypocras, Haly, and Galien ; 
Serapion, Razis, and Avicen ; 
Averrois, Damascien, and Constantyn ; 
Bernard, and Gatesden, and Gilbertyn. 
Of his diete mesurable was he, 
For it was of no superfluitee, 
But of greet norissing and digestible. 
His study was but litel on the Bible. 
In sangwin and in pers he clad was al, 
Lyned with taffata and with sendal ; 
And yet he was but esy of dispence ; 
He kepte that he wan in pestilence. 
For gold in phisik is a cordial, 
Therfore he lovede gold in special. 

In Langland's Vision of Piers Ploughman the 
Ploughman appeals to Hunger as follows :^ 

3et I prey 30W ; quod Pleres • par charite, and 56 kunne 
Eny leef of lechecraft • lere it me, my dere. 
For somme of my seruauntz • and my-self bothe 
Of al a wyke worche nou3t • so owre wombe aketh. 

Hunger thereupon tells him that he has eaten too 
much, and that he should never drink without eat- 
ing. Neither should he eat unless hungry, and ' Lat 
no3t Sir Surfait sitten at thi borde '. 

Hunger concludeshis advice as follows (11. 270-279) : 

And 3if thow diete the thus • I dar legge myne eres, 
That Phisik shal his furred hodes • for his fode selle, 

' Skeat's ed., Clarendon Press, 1886. B. Passus vi. 1. 255. 


And his cloke of Calabre ^ • with alle the knappes of 

And be fayne, bi my feith • his phisik to lete, 
And lerne to laboure with londe • for lyflode is swete; 
For morthereres aren mony leches • lorde hem 

amende ! 
Thei do men deye thorw here drynkes • ar destine 

it wolde. 
'By seynt Poule' quod Pieres-' thise aren profitable 

Wende now, Hunger, whan thow wolt • that wel be 

thow euere 
For this is a louely lessoun • lorde it the for-5elde ! ' 

But perhaps the most remarkable and lowest 
estimate of physicians is that to be found in the works 
of Petrarch, 1304-73. 

He had a hatred of physicians, and wrote four 
books of Invectives against them, and from the 
Venice edition of his works, dated 1503, Brit. Mus. 
Catalogue 11 421, K. 13, I have extracted the follow- 
ing passages. No. i is a letter to the Pope, which 
serves as the origin of and preface to the four books 
of Invectives. No. 2 is from the first book, and 
No. 3 from the second book. 

Apparently it was the universal mediaeval tradition 
that medical men were always pale. 

'A letter of Franciscus Petrarcha, the most eminent 
poet and orator to the Roman Pontiff Clement VI, 
exhorting him to avoid the mob of medical men. 
And the abuse which medical men poured upon him 

^ Calabre^ a grey fur from Calabria, the belly of which was black. 
Knappes are knobs, or buttons. 


on this account gave rise to the four books of 
Invectives which he afterwards wrote. 

( I ) ' The news of your fever, Your Blessedness, made 
me shudder with horror in all my limbs. I do not 
say this out of mere politeness, nor like him of whom 
the satirist says,^ "He weeps if he sees his friends 
cry," or again, " If his friend says* I am hot* he sweats 
at once " ; but rather I follow his example, of whom 
Cicero tells us, who was anxious about the health of 
the Roman people because he saw that it involved 
his own. For not only my own well-being but also 
that of many is founded on yours. My fear, therefore, 
is no pretence, neither am I anxious about another's 
danger, but about my own, for all we who depend 
upon you, and whose hope is in you, may appear to 
be well when you are sick, but we are not so. 

' Because, therefore, in this matter, any discourse 
which is poured forth from a human mouth into 
divine ears should be short, I, who am lowly in mind 
and of a reverential spirit, will be brief. 

M know that your sick bed is continually besieged 
by physicians, a fact which is my chief cause of 
terror, for they disagree of set purpose, and even he 
who can bring forth nothing new is ashamed to follow 
in the footsteps of another. 

' Neither is there any doubt (as Pliny gracefully says) 
that they are always hunting after renown for some 
novelty and so traffic in our lives. Also in this 
art alone does it happen that a man is taken at his 
own valuation, and that any one who holds himself 
out as a physician is at once accepted as such ; but 
although in no form of fraud is there greater danger, 
yet we do not regard it, so great is the attraction of 
a man's own particular delusion. Besides there is no 

^ Juvenal, iii. loo et seq. 


law to punish human ignorance, no exemplary 
capital penalty ; ^ they learn by our danger and gain 
experience through our death. The physician alone 
can kill a man with absolute impunity. 

' Remember, therefore, most gracious Father, the 
epitaph of that unhappy man who ordered nothing 
to be inscribed upon his tomb but " I died from a 
mob of physicians ", and let the memory turn your 
attention from that mob which like an enemy's host 
(now surround you). 

' The prophecy of M. Cato the elder seems to apply 
especially to this our own time, namely that whenever 
the Greeks should hand down to us their learning, 
and above all their medical men, they would corrupt 
all things. 

' In the present day, however, we do not venture to 
live without physicians, although unnumbered mighty 
nations live very much more happily and healthily 
without them than we do, to say nothing of the 
Roman people who flourished exceedingly, as Pliny 
says, for more than six hundred years. 

' Therefore I implore you, choose one out of the 
many who surround you, not on account of his 
eloquence, but as being conspicuous for his know- 
ledge and trustworthiness ; for now, forgetful of 
their own profession, they have dared to come forth 
from their lairs and seek the grove of the poet and 
the rhetorician's field of action, and, not with any idea 
of healing, but merely to gain a dialectical advantage, 
they surround the beds of our unhappy sick and 
dispute with mighty bellowings. 

' Moreover, when the sick are dying, though the end 
be unfortunate they give themselves airs by tangling 
up Hippocratic problems in a web of Ciceronian 
oratory. (" Hippocraticos nodos Tulliano stamine 

^ Pliny's words are ' capitale nullum exeniplum ', but Petrarch 
omits the capitale. 


permiscentes, sinistro quamvis eventii superblunt ") ; 
nor do they brag about the efficiency of their 
remedies and treatment, but only of the empty 
prettiness of their language. 

' Lest any one of your physicians should say that I 
am inventing, I have rested my arguments nearly all 
through this letter upon him whom I so often quote, 
namely Pliny, for he constantly mentions medical 
men, and speaks of them more often and more truly 
than any one else. Let them therefore hear 
him. It is obvious, he says, that any one among 
them who has a fluent tongue {loquendo pollcat) 
on that account becomes master of our life and 
death. But my pen has carried me far beyond 
the limits which I had set myself, so let me here 
make an end, by telling you to shun a physician who 
is eminent not for his knowledge but solely for his 
powers of speech, as you would a lurking assassin or 
a poisoner.' 

(2) ' In this point, too, we disagree, in that you say 
that the performances of medical men are wonderful. 
What performances, I ask you, unless you reckon 
this among the miracles, that you among all classes 
of men are nearly always ill. And so among large 
populations one can always tell your complexion by 
its pallor.' 

In cap. 18 of Bk. ii he enlarges upon this point 
in the following words. I have not translated them, 
for they require the pen of a Swift to do them 

(3) ' Ostendam tibi ego, qui non sum medicus, et 
logica careo, palloris tui causam, quam veram esse 
senties, vel invitus. Is per loca atra, livida, foetida, 
pallida. Undantes pelves rimaris, aegrotantium uri- 
nas adspicis, aurum cogitas. Quid igitur miri est, 
si tot circum pallidis, atris ac croceis, ipse quoque sis 


pallidus, ater ac croceus ? Et si grex ille providen- 
tissimi patriarchae colorem traxit, objectu virgarum 
variarum, quid novi accidit, si tu qiioque — expectas, 
ut ab auro dicam. Immo vero ab objectis. Mul- 
tiim distuli, ac libentius tacerem, sed materia verum 
nomen exigit, quodsi saepe in libris sacris est, semel 
in his scriptum tolerabitur : ab objectis inquam, ster- 
coribus, et colorem, et odorem traxeris et saporem.' 

In connexion with the phrase ' et logica careo' it 
is interesting to note that logic was laid down as 
being necessary for a medical man in the decree of 
Frederick II quoted above. 

The regulations for the duties of the medical man, 
and the fee which he was allowed to charge, were 
laid down in the statute of Frederick II De-Medtcis, a 
portion of which has been already referred to at p. 21. 
The remainderdealswith fees, &c., and is as follows: — 
Every physician was to visit his patients at least 
twice in the day, and at the request of the patient 
once at night. His fee, within the City, was not to 
be more than half a gold tarenus ^ or, if outside 
the City, three tareni and his expenses, or four tareni 
if he paid his expenses himself. He was not to be 
in partnership with an apothecary, or to undertake a 
cure for a fixed sum, or to keep an apothecary's shop. 
Apothecaries were to compound their drugs at their 
own expense, which was to be certified by a medical 
man, and were to take oath that they would compound 
them according to the prescribed forms. Simple 

^ A tarenus was a gold coin weighing twenty grains, which 
would now be worth four shillings and twopence. 


drugs which were not kept in stock for more than a 
year were to be sold at three tareni an ounce. Others 
might go to six tareni. 

De Medicis Lib. iii, Tit. xlvi. 

' Iste medicus visitabit egrotos suos ad minus bis 
in die et ad requisitionem infirmi semel in nocte, a 
quo non recipiet per diem si pro eo non egrediatur 
civitatem vel castrum ultra dimidium tarenum auri. 
Ab infirmo autem quern extra civitatem visitat, non 
recipiat per diem ultra tres tarenos cum expensis in- 
firmi vel ultra quattuor tarenos cum expensis suis. 
Non contrahat societatem cum confectionariis nee 
recipiat aliquem sub cura sua ad expensas pro certa 
pretii quantitate, nee ipse etiam habeat propriam 
stationem. Confectionarii vero facient confectionem 
expensis suis cum testimonio medicorum, juxta for- 
mam constitutionis nostre, nee admittentur ad hoc ut 
teneant confectiones nisi prestito juramento : omnes 
confectiones suas secundum predictam formam facient 
sine fraude. Lucrabitur autem stationarius de con- 
fectionibus suis, secundum istum modum : de confe- 
ctionibus et simplicibus medicinis quae non consueve- 
runt teneri in apothecis ultra annum a tempore em- 
ptionis, pro qualibet uncia poterit et licebit tres 
tarenos lucrari. De aliis vero quae ex natura medica- 
minum vel ex alia causa ultra annum in apotheca 
tenentur, pro qualibet uncia licebit lucrari sex tarenos. 
Nee stationes hujusmodi erunt ubique, sed in certis 
civitatibus per regnum ut inferius describitur.' 

Anatomy and the Decree of Pope Boniface VIII. 

It has frequently been stated that anatomy was 
looked upon by the Church with horror, and that the 
practice of dissecting human bodies was prohibited 


by a Decree of Boniface VIII. The study of human 
anatomy was, however, if not encouraged, at least 
not prohibited, for Mondinus, circa 1300, used to 
study human anatomy by dissection, and, as has 
already been mentioned, the Emperor Frederick II 
ordered that all surgeons should undergo a course 
of human anatomy before being allowed to practise. 
The decree of Pope Boniface dealt with an entirely 
different matter. The practice against which the 
decree was issued was that of boiling down corpses 
on the battlefield, so that the bones might be brought 
home for burial. This custom obtained in the army 
of Barbarossa and also in the Crusades. Probably 
the decree was taken to forbid the mutilation of 
human bodies for any purpose other than punitive, 
but the original intention had nothing to do with 
learning (Appendix C). Even vivisection of human 
beings was not unknown both to surgeons and lay- 
men of an inquiring turn of mind. 

Salimbene, in his Chronicle, tells the following tale 
of the Emperor Frederick II : 

* He fed two men most excellently at dinner, one 
of whom he sent forthwith to sleep, and the other to 
hunt ; and that same evening he caused them to be 
disembowelled in his presence, wishing to know 
which had digested better, and it was judged by the 
physicians in favour of him who had slept.'^ 

In a recently published work by the same author, 

^ Coulton, Fro7n St. Francis to Dante, Duckworth & Co., 
1908, p. 243. 


a perfect storehouse of mediaeval lore,^ is the follow- 
ing story translated from the 'God's dealings' of 
Guibert de Nogent, col. 798 ; Guibert de Nogent 
was born 1053, and became Abbot of Nogent sur 
Coucy. He died about 1 123. 

' Baldwin (afterwards King of Jerusalem) had been 
wounded in battle while he rescued a foot soldier of 
his army with whose bravery he was much delighted. 
The leech whom he summoned feared in his foresight 
lest the cataplasm outwardly applied might film over 
the wound, which, as he knew, had pierced deep into 
the prince's body ; he feared, therefore, lest, while the 
skin grew smooth over the wound, it might rankle 
inwardly with a mass of putrid matter. This he 
foresaw in his wondrous skill, partly by a most praise- 
worthy conjecture, and partly from past experience. 
He therefore besought the king to command that one 
of the Saracen prisoners (for it would have been 
wicked to ask it of a Christian) should be wounded 
in that same place and afterwards slain ; whereby he 
might inquire at better leisure in the dead man's 
body, nay, might clearly perpend from its examina- 
tion how it was with the king's wound at the very 

' From this, however, the prince's lovingkindness 
shrank in horror ; and he repeated that ancient 
example of the Emperor Constantine, who utterly 
refused to become the cause of any man's death, even 
of the basest, for so small a chance of his own safety. 
Then said the doctor: " If indeed thou art resolved 
to take no man's life for the sake of thine own cure, 
then at least send for a bear, a beast that is no use 
but to be baited ; let him stand erect on his hinder 
paws with his fore feet raised, and bid them thrust 

' Coulton, A Mediaeval Garner, Constable & Co., 19 10, p. 55. 


him with the steel ; then by inspection of his bowels 
after death, I may in some degree measure how deep 
that wound is, and how deep thine own." 

' Then said the king : " We will not strain at the 
beast, if need be, do therefore as thou wilt." Where- 
upon it was done as the leech bade; and he discovered 
from the proof of the wild beast how perilous it 
would have been for the king if the lips of the wound 
had become united before the matter had been drawn 
forth and the bottom had grown together. Let this 
suffice concerning the king's pitifulness.' 

The Saracen captive was certainly fortunate in 
not being a prisoner of Frederick II. 






Information as to a teaching School of Medicine 
in Oxford during and before the fourteenth century 
is scanty in the extreme. The tradition as to 
a School of Medicine ' which we find established in 
the twelfth century ', and ' which can hardly have 
been other than Jewish',' has, despite the authority 
of Mr. C. W. Boase and Mr. J. R. Green, apparently 
no foundation in fact, Neubauer ^ quotes Boase's 
statement in what may be called a negative manner. 
As my own knowledge on the matter was next 
to nothing, I was forced to apply to those who 
had much, and I wish to record in this place my 
gratitude to them for their kindness and help. 
Mr. I. Abrahams, Reader in Rabbinical Literature 
at Cambridge, wrote, ' I do not believe myself in 
a Jewish Medical School at Oxford in the Middle 
Ages.' Mr. J. M. Rigg, of Lincoln's Inn, says that 
his researches into mediaeval Jewish History have 

^ Historic Towns : Oxford; Short History of the English People. 
"^ ' Notes on the Jews at Oxford,' Oxford Hist. Soc, Collectanea, 
1890, vol. ii. 


in no way tended to confirm the statement. Neither 
the late Professor Steinschneider of Berlin nor 
Mr. A. Weiner of London believed in the School, 
and finally Dr. R. L. Poole says that he does not 
believe that there is any evidence for a School of 
Medicine at Oxford, either Jewish or Christian, at 
the date mentioned. 

There is, however, evidence of medical teaching at 
Oxford before a. d. i 200, for Robert Grosseteste, 
afterwards Bishop of Lincoln, had while at Oxford, 
which he left on the first occasion before 1200, 
acquired sufficient medical knowledge to be physician 
to the bishop. At a later date, Adam de Marisco, 
writer to Grosseteste, about the year a.d. 1250 says : 

' Cum venissem ad Oxoniam . . . locutus sum etiam 
cum magistro Reginaldo de Stokes, medico, viro 
maturo et honesto, in artibus et in medicina provecto 
et experto, quem et conversatio socialis, et circum- 
specta discretio, et sermo maturus, et timorata 
devotio, juxta fide dignorum assertionem, plurimum 
reddit acceptum.' 

He goes on to advise that Reginald be taken into 
the Bishop's service.^ 

That there were leeches {^Medici) in Oxford in the 
twelfth century is evident from a story given by 
Dr. T. E. Holland "- concerning the cure of a student, 
date circa 1 1 80. The passage is taken from the 
Acta Sanctorum, Octobris, t. viii, p. 579, being 

^ Monitmenta Franciscana, vol. i, p. 113 ; Rolls Series. 
"^ Oxford Hist. Soc, Collectanea, vol. ii, 1890. 'The Twelfth 
Century University.' 


a portion of the Historia Miraculorum Sanctae 
Frideswidae Virginis, cum prologo, per Philippum 
ejus dent Monasterii Prior em : — 

* Morabatur eo tempore apud Oxenefordiam, stu- 
diorum causa, clericus quidam Stephanus nomine, de 
Eboracensi regione oriundus, aetate juvenili floridus, 
et elegantia formae praeclarus. Is febre cotidiana 
correptus, ad medicorum confugit auxilium, inanibus 
se sumptibus eviscerans, languoris acerbitate singulis 
ingravescente diebus. Ad divinum igitur, tanquam 
ad ultimum, cum jam deficeret humanum, convolavit 
adjutorium, et cum jam, nimia macie confecta, vix sibi 
membra cohererent, oculis liventibus, facie pallida, 
Virginis gloriosae patrocinium implorabat. Mox 
itaque, ut aquae benedictae poculum hausit de cetero 
febrilis fatigatio conquievit. Et redeuntibus paulisper 
viribus in brevi ad plenum convaluit.' 

Prior Philip succeeded his predecessor in iiSo, 
and in the first year of his office translated the 
remains of the Saint, whereupon many miracles 

Whether the medici upon whom poor Stephen 
wasted his substance, with the same results as did 
the woman with the issue of blood mentioned in the 
Gospels, were Jewish or Christian there is no record, 
but this is the earliest record of leeches in Oxford 
that I have been able to find. There were, however, 
two medical or quasi-medical charities founded circa 
the twelfth century, one being a hospital for lepers 
dedicated to St. Bartholomew and the other the 
Hospital of St. John Baptist which was just outside 
the East Gate, but these will be more conveniently 


dealt with when considering the question of what 
opportunities Gaddesden may have had of learning 
his profession. 

The medical books which he was probably obliged 
to have read or heard before supplicating for his 
degree ^ have already been mentioned, but a study of 
the Rosa reveals the fact that he had read, or was 
acquainted with, a large number of authors, and, 
moreover, with the most recent medical works, for 
he quotes Bernard of Gordon, who began his Lilium 
Medicinae in 1305. A complete list of the authors 
quoted or referred to by Gaddesden will be found in 
the Appendix ; some of them, chiefly Arabic writers, 
cannot be identified. 

As to the medical works existing at Oxford in the 
time of Gaddesden there is but little information. 
The list of authorities whom he quotes shows that 
he was a man of wide reading in medical matters, so 
that he must have had access to books ; but as to 
where he read them there is no record. One of the 
earliest Oxford Library Catalogues extant is that of 
Oriel College, 1375.^ But in this there are no 
medical works, the only books mentioned which may 
be said to have any connexion with medicine being 
two copies of Aristotle's Liber Naturalium and one 
of his Liber de Gcncraiione? 

^ ' Probably,' for the date of the earliest MSS. from which the 
statutes are taken is not earlier than 1350, and most are much 
later. ^ O. H. S., Collectanea^ vol. i, 1885. 

^ This may mean either de Generatione et Corruptione, or de 
Generatione Animalium. 

1302 H 


William of Wykeham gave a large gift of books 
to his College of St. Mary of Winchester in Oxford, 
alias New College, and the catalogue of them will be 
found in the third volume of the Col/ectanea of 
the Oxford Historical Society, in an article by 
Mr. A. F. Leach. Amonsf them are a number of 
medical books given under the heading of ' Libri 
Facultatis Medicinae ' ; but the list, says Mr. Leach, 
is in another, and apparently later, hand than the 
other lists, and whether they formed part of 
Wykeham's gift is uncertain. The list is in two 
parts, the first of which contains the books which 
might be taken out, while the second gives the books 
which were chained in the library. 

The authors in Part I are Galen, Nicolaus, 
Bartholomaeus, Rhazes, Averrhoes, Hippocrates, 
Gilbertus Anglicus, and Gerrardus. 

In Part II the authors are Galen, Averrhoes, 
Avicenna, Mesne, Benvenutus Graphoeus, Gilbert, 
a Commentary by Joannes Alexander upon the 
Epidemica of Hippocrates, Bernardus, Gerardus, 
Dioscorides. There are tvv^o copies of the Rosa and 
another book apparently by Gaddesden entitled 
Super aff.^ of which nothing is known. Super off. 
might mean either ' super affectibus ', or * super 
afforismis '. 

In another article, ' Some Durham College Rolls,' ^ 
by the Rev. H. E. D. Blakiston, a list of books is 
given in a roll dated 1315, and in this roll are the 

' O. H. S., Co/lectafiea, vol. iii. 


following books, which are either medical or have a 
bearing on medicine : Liber Naturalium ; Quesliones 
super natter a/ia et logicalia ; Nohde super librum de 
plantis et stiper librum celi et mundi et recapitula- 
ciones libri Metheororum et P hisicorum ; Exposicio 
Thomae de Aquijio snper libros phisicorum ; Libri 
Natiirales Avicennae et Algazel ; Ysidorum {sic) 

Books in the Middle Ages were, as a rule, the 
property either of corporations or of rich folk, and 
the regular corporations, such as the great abbeys, 
were far richer in literary treasures than were secular 
corporations such as the University of Oxford. It 
is probable that Gaddesden may have studied some 
of the authors whom he quotes in the libraries of 
Oseney Abbey, or St. Frideswide's Abbey, and as 
the King's physician he would be in a better position 
for obtaining access to libraries than an ordinary 

How valuable and varied was the collection of 
books in the library of a great religious house may be 
seen by the catalogues of the ancient libraries of 
Canterbury and Dover, which have been printed by 
Dr. Montague Rhodes James (Cambridge University 
Press, 1903). The catalogues are those of Christ 
Church Priory in the time of Henry of Estry, who 
was Prior from 1284 to 1331, and so a contemporary 
of Gaddesden ; of St. Augustine's Abbey, drawn up 
about the end of the fifteenth century ; and of Dover 
Priory, compiled in 1389. 

II 2 


There are medical books in all three catalogues ; 
St. Augustine's catalogue contains over 230 treatises, 
that of Christ Church nearly 300, and that of Dover 
Priory about 1 20. St. Augustine's catalogue contains 
the following authors not quoted by Gaddesden : 
Alguensid, Quintus Serenus, Macer, Genesius, 
Maurus, Trotula, and Costa ben Luca. It is possible 
that the Alguensid of the catalogue may be the 
Alguasinus of Gaddesden. Most of the authors 
quoted by Gaddesden were in the library, and it was 
particularly rich in the works of Constantine and in 
copies of the Ysagoge of Joannitius. 

The Christ Church Catalogue contains the Aphor- 
isms of John Damascene, an author unrepresented 
in St. Augustine's library, and also at least three 
copies of his Ysagoge ad Tegni Galeni. This book 
apparently is not a confusion on the part of the scribe 
with the far better known Ysagoge ad Tegni of 
Joannitius, for in vol. 448 the two are bound up to- 
gether {James, op. ciL, p. 56). But the most in- 
teresting items in the catalogue are those dealing with 
the books given by Magister Robertus de Cornubia, 
Medicus, vols. 1706-14 (p. 138); they are: Dtco 
primi libri Avicennae ; Novi tractattis yohannis 
Mesne cum practica averois de medicina cum qiLcstio- 
nibus super tiiaticiim ; Practica Gilder li ; Libri 
Origifiales Ypocratis et Galieni ; Scripta Magistri 
Thedei C2Lm quibusdam aliis conteniis ; Viaticus 
Constautini cum Commcnto ; Liber Hali de regali 


Gilbertus (Anglicus), the latest in this list of 
authors, flourished early in the thirteenth century, 
so that Robert the Cornishman was probably nearly 
a contemporary of Gadclesden, and we may rightly 
imagine that Gaddesden might have had a similar 
or even superior private library. 

Among the authors not quoted by Gaddesden 
which are found in this catalogue are Matthesus 
Ferrarius de febribus ; Geraldus, de dandis cathar- 
ticis ; Alfanus Salernitanensis ; Genesius ; Soranus ; 
Pliny, and Bartholomaeus. There are also two 
treatises by Alexander Sophista. The one treatise 
is called De Medicina omniitin membi^orum huniani 
corporis, and the other De curis huniani corporis. 
The remaining medical works are mostly standard 
authors such as Galen, Hippocrates, Egidius (Cor- 
boliensis), Constantine, Philaretus, Theophilus (the 
last two are probably the same person), Platearius, 
and the Aniidotarium of Nicolaus. 

The medical works in the Dover Priory catalogue 
are in many instances those of quite unknown authors. 
It is true that there are works by Joannitius, Hippo- 
crates, Galen, Razes, Trotula, Nicolaus, Platearius,and 
Gilbert, but the catalogue also contains such books as 
Medicinale //tilderti, Medicinale mediciec, and Practica 
Alexandri Nic/wlai, all three of which are briefly 
annotated by the compiler of the catalogue John 
Whytefeld, as Mostardyer. Dr. James suggests 
that this means that the books were so dilapidated 
that they were only fit for wrapping up mustard. 


From these three catalogues, therefore, it is pos- 
sible to form a very good picture of the facilities for 
reading medicine which any enthusiastic medical 
writer of the fourteenth century could obtain. 

It is not, however, unreasonable to suppose that 
Oxford possessed single copies at least of the same 
medical works as were at Montpellier. A list of these 
which were in use 1 309-1 340 can be found in 
Hastings Rashdall, Universities of Europe,vo\. ii, pp. 
2, 780. The fame of Montpellier as a medical Uni- 
versity was, of course, far superior to that of Oxford, 
for the number of medical Doctors at Oxford was 
always small. Books, however, despite the difficulties 
of reproduction, must have been diffused with amazing 
rapidity in the Middle Ages, and as Oxford had a 
Faculty of medicine that Faculty probably possessed 
some books, even before the New College bequest. 

Duke Humphrey's library contained a number of 
medical books, but the date of his bequest, 1439, was 
over a hundred years after Gaddesden's period of 

What opportunities for study had the student of 
medicine in Oxford apart from books ? There were 
at least two endowed hospitals where poor sick people 
were cared for, or at least which had been founded 
to that intent. One was the hospital of St. Bartho- 
lomew founded by Henry I, 1100-1135, and the 
other the hospital of St. John Baptist founded either 
by King John, 1 199-1216, or more likely by Henry 
III in 1233. 


Concerning St. Bartholomew's, it stood ^ 'on the 
east side of Oxon, a quarter of a mile distance from 
St. Clement's.' In those days St. Clement's Church 
stood at the east end of the bridge which is now 


Magdalen Bridge. Here Henry I erected a chapel 
to the memory of St. Bartholomew, being guided 
perchance in his choice of a saint by the thought of 
the great house just founded in London and some 
edifices adjoining for leprous folk. The house, 
however, fell on evil times in the reigns of Edward I 
and Edward II, it being so poor that the original 
foundation of twelve brethren was reduced to six by 
Edward I. His successor would have restored it, 
but in 132 1 a report arose that the leprous folk in 
transmarine parts had at the instance of the Saracens 
' poisoned the fountain of sweet gliding streams . . . 
Then were they upon shrewd suspicion of the same 
fact in England utterly hated and their hospitals 
brought for the most part to great decay.'^ 

It is not very likely, then, that during the time 
when Gaddesden was studying medicines there 
were many patients in the hospital for him to see. 
If there were any it is extremely likely that they 
included certain cases of chronic skin diseases besides 
those of true leprosy. The word lepre or lepra was 
probably used in an elastic sense. In ' The Govern- 
ayle of HeltJie\ ascribed to John of Burgundy and 
printed by Caxton, is the following note : 'And know 

^ A. Wood, City of Oxford, ed. Clark^ Oxford Hist. See, vol. ii, 
1890. - Wood, loc. cit. 


when thou wolte and note it for a souveraiene nota- 
bility who that eateth oft milk and fish, oft catch 
thereof a lepre or a white scab.' ^ If lepre here 
does mean 'leprosy' the passage is interesting as 
regards a certain controversy concerning fish and the 
question of tuberculous infection by milk. 

The other endowed hospital, that of St. John 
Baptist, stood about where now stand the tower and 
the kitchen buildings of Magdalen College. There 
was a religious house of the name founded by King 
John, 2 but, continues Wood, ' We will according to 
most authors take King Henry III to be the 
founder and not the rebuilder.' The foundation charter 
is dated 1231. But among the Bodleian MSS. is a 
fifteenth-century copy of the statutes,^ and at the end 
of the statutes comes a paragraph stating that they 
were * confirmed by the Venerable and most holy 
father Innocent, at the petition of the illustrious 
King of the English, Henry III, who was the 
founder of this hospital. Given at Avignon the 
tenth of the Kalends of April in the third year of 
his Pontificate. At that time was Hueh made 
Bishop of Lincoln '. 

The dates are confused : the third year of Innocent 
IV was 1246, i. e. the thirtieth to the thirty-first year 
of Henry HI. But the great St. Hugh was Bishop 
of Lincoln from 11 86 to 1200 ; Hugh of Wells was 

^ This statement is found in Avicenna, 

^ Wood, op. cit., p. 520. 

^ Press mark in 1911 ; MS. Top. Oxon. d. 8. 


bishop from 1209 to 1235. The scribe may possibly 
have been thinking of ' Little St. Hugh of Lincoln ', 
whose date is traditionally 1246-55. 

Whatever be the date of the statutes, it is evident 
from them that the hospital was primarily a religious 
house. The officers were three, a Master, a Steward 
(celerarms), and a Sacristan. The Master was to be 
chosen by the brethren, and had to exercise a 
general supervision over the inmates, but he was to 
show no favouritism : ' Equalis caritas dilectionis de- 
betur omnibus.' The Steward, whose duties were in 
some ways the most onerous, had among other things 
to look after the welfare of the sick poor ' guests ' 
who came to the hospital : ' Omni sollicitudine curam 
gerat infirmorum pauperum hospitum supervenien- 
tium.' The duty of the Sacrist was to look after 
the choir {cJiorum regeiis), i. e. not merely the singers, 
but the building, the books, the music, and to see that 
the proper offices were duly sung. He also had in 
his charge all the ornaments of the church. In 
addition, as to him was committed the charge of the 
infirmary, the statutes proceed : 'We ordain and defi- 
nitely command that he shall hear the confession of 
any sick person seeking admission before that he be 
admitted. If the infirm be adults, none of the follow- 
ing shall be admitted : those suffering from leprosy, 
paralysis, dropsy, mania, epilepsy, fistula, or incurable 
diseases. Neither shall any pregnant . . . woman 
[utulieres . . . praegnantes) nor young girl be admitted. 
For these should rather have outdoor relief, if they 


are in need as well as ill, until they shall be well 

The statutes also contain rules for the admission 
and conduct of the brethren and sisters of the house, 
and the oath which they took on the gospels ran as 
follows : ' I vow to Almighty God and to St. John 
the patron of this church, that I will live honestly 
and chastely according to the statutes of this house, 
and that I will serve the poor as I should in the 
said house : so help me God and these holy 

The statutes show that the hospital was in the 
main a religious house. As for the patients, they 
would seem from the passage just quoted to have 
been limited to those suffering from acute disorders 
such as fevers and other pyrexial complaints, for the 
class of case mentioned as forbidden admission 
includes most chronic disorders. The leprosi pro- 
bably meant any skin disease ; paralitici ruled out 
all old hemiplegias and many diseases of the spinal 
cord ; ydropici swept away nephritis, most kinds of 
morbus cordis, cirrhosis of the liver, and possibly 
sundry abdominal tumours ; epilepsy and incurable 
diseases were banned; and finally pregnant women 
were not allowed to share in the charity. 

There remain the specific fevers, ague, and such 
complaints as pneumonia and bronchitis. Here 
there would be a small amount of clinical material 
for any one who was reading for a degree in the 
medical faculty to study, but as no clinical study was 

o 1 


necessary for a degree, probably no student, unless 
unusually enthusiastic, would trouble about it. 

Besides this collection of sick folk they might also 
have been found round the various holy wells, such 
as St. Margaret's at Binsey, and St. Edmund's near 
the east end of (now) Magdalen Bridge. 

Then there were the infirmaries of the great 
religious houses such as Oseney Abbey and St. 
Frideswide's Priory. Wood in talking of the last 
named says : ' Then there was the infirmary where 
the monks that were sick retired and had the benefit 
of phisicians and their medicines.' This looks as if 
a physician who was not a member of the community 
might occasionally have been called in. Probably, 
however, the monastic physician was a kind of lay 
brother, or at least he could take fees, for in the 
Chronicle of Jocelin of Brakelond^ it is said : 'Our 
almonry which previously was of wood and out of 
repair, was built in stone ; whereto a certain brother 
of ours, Walter the physician at that time almoner, 
contributed much of what he had acquired by his 
practice of physic' 

Other opportunities for study were provided by 
the operations of the law. Thus Bernard of 
Gordon in his Liliuni Medicinae- says in the 
section on disease of the oesophagus, which the Arabs 
called Meri, that the stomach has a natural attraction 
for food. He continues: ' So we see that in Jews, 

' King's Classics, ed. Moring, London, 1903, p. 146. 
- Ed. Francofurti, 1617, p. 530. 


when they are hung up by the feet, food is none the 
less drawn into the stomach, which would not happen 
unless the natural energy of the stomach drew it up 
and made it ascend.' 

Executions too, at least by decapitation, might 
surely have suggested to a medical observer that the 
arteries did not carry spirits but blood, and yet this 
fact was not grasped until Harvey's time, although 
Galen was aware of it. 

Such, then, so far as we can see, were the 
opportunities for clinical study in mediaeval times, 
and Gaddesden at any rate must have seen a good 
number of patients before writing the Rosa, but 
whether he made any use of the possible opportunities 
for study before taking his degree is very doubtful. 



Eg. 1065. Les Commentaires de Cesar, f. 9, Caesarian operation. 

17 F. ii. La Gratide Histoire de Cesar: made at Bruges for 
Edward IV. f. 9, Birth scene. 

16 G. viii. Les Co7nmentaires de Jules Cesar, f. 32, Caesarian 
operation (f. 39 ?). 

6 E. vi. Omne Boniivi : Collection by various authors, f. 122 b, 
Lying ill. f. 258 b, Trepanning, f. 503 b, Teeth extrac- 
tion. Other ff. 546 b, 547 &c. 

10 E. iv. Decretals, f. 67 b, Cupping operation. 

Sloane, 2435. Livre pour garder hi saiiie, par Aldebranius de 
Sienne. Many small miniatures of various medical scenes, &c. 

Add. 24, 189. John Ma7idevilk' s Travels, f. 4, Portrait of John 
Bordeaux — La Barba. 


Hastings Rashdall. The Universities of Europe in the Middle 

Ages. Clarendon Press, 1895. 
Anstey. Mufiimetita Academica. Rolls Series. Longmans, 1868. 
Huillard-Breholles. Historia Diplomatica Friderici LL. 

Paris : Plon, 1854. 
Freind. History of Phy sick. London, 1750. 
Cardan, J. De Propria Vita. Amsterdam, 1650. 
Croke. Regimen Sanitatis Salernitanu7n. Oxford: D.A. Talboys, 

IsiDORUS HisPALENSiS. Liber Etymologiarutu. Venice : Loslein, 

John of Salisbury. In Migne's Patrologia Latina. The 

Policraticus, edited by C. C. J. Webb. Clarendon Press, 1909. 
Lounsbury. Studies in Chaucer. London : Osgood, Mcllvaine & 

Co., 1892. 


Simpson, Sir J. Y. Archaeological Essays. 

Decretaks, Lib'er Sextus, Bonifacii VIII. Lyons, 1584. 
Leyser. Historia Poet, et Poeniat. Med. Aev. Halae, 1741. 
Henslow. Medical Works of the Fourteenth Cetitury. Chapman 

& Hall, 1894. 
LuciEN Leclerc. Histoire de la Medecine Arabe, 2 vols. Paris : 

E. Leroux, 1876. For information as to Arabic writers and 

translators from the Greek, and as to mediaeval translators 

from the Arabic into Latin. 
E. B. WiTHiNGTON. Medical History from the Earliest Times. 

London: The Scientific Press, 1894. Consulted for its 

admirable list of authorities and editions of mediaeval writers. 
Articella. Lyons : John De La Place, 1515. 
Mojiumenta Franciscana. Rolls Series. 
M. R. James. Catalogues of the Ancient Libraries of Canterbury 

and Dover. Cambridge University Press, 1 903. 
C. Vieillard. Gilles de Corbeil. Paris : Librairie Ancienne, 

Honore Champion, 1909. 



Nicolaus Scyllatius Siculus magnifico ac praestan- 
tissimo Ambrosio Varisio Rosato, Diicali Physico ac 
Consiliario sapientissimo S(alutem) D(icit). 

Qui de diis scripserunt, Ambrosi eruditissime, 
iinum imprimis eos genus hominum veteri gentium 
opinione in celo coUocasse animadverto, qui se 
videlicet ad homines conservandos juvandosque 
natos existimarent. Nam et quos ApoUines, 
Cereres, Liberos, Hercules, Aesculapios antiquitas 
coluit ; homines olim fuisse Aegyptus primorum 
animantium parens non falso commemorat. Sed 
merita propter eximia quae in societatem humanam 
praestiterunt, mox deorum vocabulo nuncupatos, Et 
sane si paulo semotius tecum haec : nihil praeclarius 
aut deo optimo maximo similius invenies, quam ubi 
te beneficum omnibus indulgentemque praestiteris. 

Quo fit ut te felicem et perbeatum non temere 
homines nostri seculi et judicent et existiment, quod 
in omne genus hominum perpensus obviusque et 
expositus semper occurreris : consulendoque agendo : 
atque ut es medicinae et astronomiae scientissimus, 
morbos propellendo, siderum minas . furoresque 
superum avertendo, et regna confirmaveris, et amici 
diem nunquam perdideris. Omitto quot patrocinio 
defenderis, quot spoliatos reduxeris, damnatos libe- 
raveris, ut jam illud de te libere decantare liceat, 
plures unum Ambrosium physicum causas agere, 
quam centum istos pragmaticos ac leguleos. 


Cum semper honorificum ac religiosum existl- 
maveris, ut quantum gratia et auctoritate apud in- 
victissimum principem Ludovicum Mariam Sfortiam 
valeres, aliorum honorlbus et commodis experirere. 

Tantum autem te studiosi et literati viri de se 
benemeritum esse fatentur, ut nemo ferme sit qui 
studia amet, quin te quoque bonarum artium nomine 
colat et veneretur. Legis passim de te historias, 
poemata, actiones, et posteritati tuae (quod raris- 
simum homini datur) praesens es. Quin illud ausim 
dicere, nullum te genus hominum ad beatitudinem 
tibi et eternitatem aptius obligare potuisse quam 
disertissimos viros. Possem multos nominare in 
Italia, qui a te singulare presidium susceperunt, 
nisi vererer ne epistolae modum excederem. 

Nam eos tuae beneficentiae praecones citare, quia 
Mediolani quottidie ante oculos versantur, superva- 
caneum esse arbitror. Testis est universa academia 
Ticinensis, quae tantum fastigium te patrono, tum 
sapientium celebritate, tum salariorum magnitudine 
accepit, quantum nunquam ante Ambrosium Rosatum 
majores nostri viderunt, posteri gaudebunt. Ego 
vero isto tempore studiorum nomine quae sub te in 
summo apice constiterunt, tum privatim, tum publice 
lector, tibique (Artaxerxis regis rustici exemplo) 
munusculum hoc doctum sane et eruditum persol- 

Nam cum loannes Antonius Birreta vir sinijularis 


exempli Ticinensium (pace omnium dixerim) optimus, 
paulo ante me admonuisset nactum se Rosarium in 
Medicina, opus rarum . . . et reconditum, juvenibus 
perutile senibus et exercitatis apprime desideratum, 
perlegendiquemihicopiamfecisset, multaibi secretiora 
animadverti, quae post alios recentiores Nicolaus 
Florentinus inprimis vir in omni medicina diligen- 
tissimus, velut apis e roseis floribus utiliora colligens 
in orrandibus suis voluminibus conoesserat. 


Nunc ut emendarem, cum idem Birreta frugalitatis 
antiquae specimen, ut est in postulando modestus 
et verecundus, rogasset, etsi rogandum cui vitam 
deberem non erat, multo labore multoque studio 
effecimus, ut quod mutilatum longi temporis situ et 
librariorum incuria depravatum fuisset, locis quae 
falso in veterum libris passim allegabantur diligenter 
recognitis, in faciem absolutam figuramque pristinam 
pro virili redderemus, ut qui Rosarius olini fuisset, 
nunc agnitus veluti ex horrida et longa peregri- 
natione, domum tandem excultus ad suos rediret. 

Te igitur patronum et dominum, Ambrosi Rosate, 
cosfnoscit, te crentis suae columen salutat, te sibi 
vindicem paravit qui regum palatia coiis et m aulis 
principum totus es. Hunc cum leges iterum legisse 
non poenitebit, tam varia et experta, tam multa et 
presentanea remedia affatim ministrat. Quo fit ut 
non temere sicuti rosam florum pulcherrimum esse, 
jam pridem apud nostros receptum est, sic liber iste 
omnium recentiorum vigilias atque artes qui de hac 
re scripserunt facile superet. Quantum vero venu- 
statis et elegantiae Rosa ipsa prae se ferat assidue 
audis, quotidie lectitas. Quae etsi inter corona- 
menta mortalium sero apud veteres recepta sit, ob 
id non debet mirari Plinius Secundus novicomensis 
conterraneus tuus. Veneris enim ea et sane deae 
potentissimae tantum fuerat, cujus numen ipsi 
quoque magni dei reformidant. Proinde apud Ap- 
thonium scriptum est : — 

Qui rosae pulchritudinem demiratur, plagam 
Veneris consideret. Sed hoc vetus est, Quam 
lepide et eleganter Libanius sophista Grecus rosam 
Veneris describens, eam floribus singulis anteponit. 
Et quoniam fabella ipsa lepidissima est, non insuave 
tibi fore duxi, si pauca ex illius contextu summatim 

Quo inquit tempore deabus pastor judex datus est, 

1302 I 


angebatur Juno, angebatur Minerva, quod cestu illo 
qui cingulus erat in quo amoris vires insunt et cupi- 
dinis, se Venus veluti medicamento quodam et forme 
lenocinio exornasset. Ita in certamine prius venturas 
negabant quam ubi a se Venus cestum deponeret. 
Dempsit dea cingulum, pacta sibi cesti vice alium 
ornatum quaerere. Ad Scamandrum pergit lectura 
tiores, qua se pratum sub ripa explicabat herbidum. 
Lota ibi dea statim qua causa venerat ornatum 
quaerebat sibi. Turn, nescio qui mire suavis aspirare 
odor visus, jam lilia jam violas legerat, quum tamen 
odor ille magis interim magisque blandiebatur. 
Pergit aurae flagrantis vestigia subsequi, videt rosam 
visamque naribus admovet et esse banc suaveolentiae 
illius matrem cognoscit. Ibi flores aspernata ceteros 
abjicit humi, tantumque rosis coronata recepit se ad 
Idam denuo. Nee, ait, plus Veneri flos quam flori 
Venus conciliare gratiam visa est. Adeoque confes- 
tim Juno et Minerva victae, ut ne ipsae quidem 
pastoris expectarent calculum, sed accurrentes 
utraque sertum crinibus detraxerint floremque 
deosculatae ipsum rursus Veneris capiti reposuerunt. 
Haec, mi patrone, ego subtexui ut primum quanti 
tua Rosa sit explicatius legeres, et mox ne ipsum 
libellum qui medicinae Rosa inscribitur gratia et 
favore defraudaremus. Conati certe sumus, ut 
quam absolutius fieri posset tuus Rosarius a 
Birreta nostro tui benevolentissimo, et a Francisco 
Girardengo socio et contubernali viro industrio ac 
diligenti ad te mitteretur. Qui etsi cetera vita 
laudatissima sunt, hoc tamen maxime excellere ]udi- 
cantur, quod nihil non ante castigatum et expolitum 
imprimendum curent. Ad tantam avaritiam et sor- 
didos sumptus ex impressoribus maxima pars lapsa 
est, ut libris perperam aut temere scriptis, non ante 
recognitis siquid imprimi jusserint in pejus semper 
verterint. Sed de his satis. Tu modo ostende (ut 


facis) tibi nostra studia et lucubratiunculas placere. 
Non deerunt qui tibi brevi majora et absolutiora 

Vale meum presidium et studiosum omnium 



The following excerpts from Huillard-Breholles's 
Historia Diplomatica Friderici II, Paris, 1854, Vol. 
iv, pt. I, p. 149, contain the regulations referred to 
on p. 21. 

Tit. lxiv. Rex Rogerius. 
De probabili experientia 7?teduorum. 

Quisquis amodo mederi voluerit officialibus nostris 
et judicibus se presentet, eorum discutiendus judicio ; 
quodsi sua temeritate presumpserit, carceri constrin- 
gatur, bonis omnibus suis publicatis. 

Hoc enim prospectum est, ne in regno nostro 
subjecti periclitentur ex imperitia medicorum. 

Ibidem, page 150: 

TiTULUs Lxv. Imperator Fredericus. 

Utilitate speciali prospicimus cum communi saluti 
fidelium providemus. Attendentes igitur grave 
dispendium et irrecuperabile damnum quod posset 
contingere ex imperitia medicorum, jubemus in 
posterum, nullum medici titulum pretendentem 

I 2 


audere practicare aliter vel mederi, nisi Salerni 
primitus in conventu publico magistrorum judicio 
comprobatus, cum testimonialibus literis de fide et 
sufficienti scientia tarn magistrorum quam ordina- 
torum nostrorum, ad praesentiam nostram, vel, nobis 
a regno absentibus, ad illius praesentiam qui vice 
nostra in regno remanserit (ordinatus accedat) et a 
nobis vel ab eo medendi licentiam consequatur ; pena 
publicationis bonorum et annalis carceris imminente 
iis qui contra hoc nostre serenitatis edictum in 
posterum ausi fuerint practicare. 

The licence was granted after the following form 
given by Huillard-Breholles : 

From Petri de Vin. EpisL, lib. vi, cap. xiii. 

Notum facimus fidelitati vestre, quod fidelis noster 
N. ad curiam nostram accedens, examinatus, inventus 
fidelis et de genere fidelium ortus, et sufficiens ad 
artem medicine exercendam, extitit per nostram 
curiam approbatus. Propter quod de ipsius prudentia 
et legalitate confisi, recepto ab eo in curia nostra 
fidelitatis sacramento, et de arte ipsa fideliter excer- 
cenda juxta consuetudinem juramento, dedimus ei * 
licentiam exercendi artem medicine in partibus ipsis : 
ut amodo artem ipsam ad honorem et fidelitatem 
nostram et salutem eorum qui indigent, fideliter ibi 
debeat exercere. Ouocirca fidelitati vestre preci- 
piendo mandamus, quatenus nuUus sit, qui predictum 
N. fidelem nostrum super arte ipsa medicine in terris 
ipsis, ut dictum est, exercenda, impediat de cetero 
vel perturbet. 

Lib, III, Tit, xlvi. 

Quia nunquam sciri potest scientia medicine nisi 
de logica ^ aliquid presciatur, statuimus quod nullus 

^ See excerpt from Petrarch, p. 104. 


studeat in mediclnali scientia nisi prius studeat ad 
minus triennio in scientia logicali ; post triennium si 
voluerit, ad studium medicine procedat, in qua per 
quinquennium studeat; ita quod chirurgiam que est 
pars medicine infra predictum tempus addiscat. 
Post quod et non ante concedatur sibi licentia 
practicandi, examinatione juxta curie formam pre- 
habita, et nihilominus recepto pro eo de predicto 
tempore studii testimonio magistrali. 

Then follows a paragraph dealing with the duties 
of the medical man and giving a scale of fees.^ The 
decree proceeds : 

Nee tamen post completum quinquennium pra- 
cticabit, nisi per integrum annum cum consilio experti 
medici practicetur. Magistri vero infra istud quin- 
quennium libros authenticos tam Hippocratis quam 
Galeni in scholis doceant, tam in theorica quam in 
practica medicina. Salubri etiam constitutione 
sancimus ut nullus chirurgicus ad practicam admit- 
tatur, nisi testimonials literas offerat magistrorum in 
medicinali facultate legentium quod per annum 
saltem in ea parte medicine studuerit que chirurgie 
instruit facultatem, presertim anatomiam humanorum 
corporum in scholis didicerit, et sit in ea parte 
medicine perfectus sine qua nee incisiones salubriter 
fieri poterunt nee facte curari. 

^ See chap, iii, p. 106. 





Cap. I 

De Sepidturis. Bonifacius Octavus. 

Detestandae feritatis abusum, quern ex quodam 
more horribili nonnulli fideles improvide prosequun- 
tur, nos piae intentionis ducti proposito, ne abusus pre- 
dicti saevitia iilterius corpora humana dilaceret, 
mentesque fidelium horrore commoveat, et perturbet 
auditum, digne decrevimus abolendum. 

Praefati namque fideles hujus suae improbandae 
utique consuetudinis vitio intendentes, si quisquam 
ex eis genere nobilis, vel dignitatis titulo insignitus, 
praesertim extra suarum partium limites debitum 
naturae persolvat, in suis vel alienis remotis partibus, 
sepultura electa, defuncti corpus ex quodam impiae 
pietatis affectu truculenter exenterant, ac illud mem- 
bratim vel in frusta immaniter concidentes, ea 
subsequenter aquis immersa exponunt ignibus deco- 
quenda. Et tandem (ab ossibus tegumento carnis 
excusso) eadem ad partes praedictas mittunt, seu 
deferunt tumulanda. Quod non solum divinae 
majestatis conspectui abominabile plurimum redditur, 
sed etiam considerationis obtutibus occurrit vehe- 
mentius abhorrendum. 

Volentes igitur (prout officii nostri debitum exigit) 
illud in hac parte remedium adhibere, per quod 
tantae abominationis, tantaeque immanitatis et 


impletatis abiisus penitus deleatur, nee extendatur 
ad alios ; Apostolica auctoritate statuimus et ordl- 
namiis iit cum quis cujuscunque status, aut generis, 
seu dignitatis extiterit ; in civitatibus, terris, seu 
locis in quibus cultus catholicae fidei viget, diem 
de cetero claudet extremum ; circa corpora defun- 
ctorum hujusmodi abusus vel similis nullatenus 
observetur, nee fidelium manus tanta immanitate 

Sed ut defunctorum corpora sic impie ac crudeliter 
non tractentur, deferantur ad loca in quibus viventes 
elegerint sepeliri, aut in civitate, castro, vel loco ubi 
decesserint, vel loco vicino ecclesiasticae sepulturae 
tradantur ad tempus, itaque demum incineratis 
corporibus, aut alias ad loca ubi sepulturam ele- 
gerint. deportentur, et sepeliantur in eis. Nos enim 
si praedicti defuneti executor vel execu tores aut 
familiares ejus seu quivis alii cujuscunque ordinis, 
conditionis, status aut gradus fuerint etiam si 
pontificali dignitate praefulgeant, aliquid contra 
hujusmodi nostri statuti et ordinationis tenorem 
praesumpserint attentare, defunctorum corpora sic 
inhumaniter et crudeliter pertractando, vel faciendo 
pertractari, excommunicationis sententiam (quam 
ex nunc in ipsos perferimus) ipso facto se noverint 
incursuros, a qua non nisi per Apostolicam sedem 
(praeterquam in mortis articulo) possint absolutionis 
beneficium obtinere. Et nihilominus ille cujus corpus 
sic inhumane tractatum fuerit, ecclesiastica careat 
sepultura. Nulli ergo &c. 

Datum Lateranensi xii Cal. Mart. 
Pontificatus nostri anno sexto. 




For the right understanding of any work on 
mediaeval medicine, it is necessary for the reader to 
understand the various technical terms employed. 
He will, for instance, always be met with such 
expressions as the ' six non-naturals ', the ' naturals ', 
and so on. These are explained in the well-known 
work the Isagoge, written by Joannitius, or, to give 
him his Arabic name, Hunain. This treatise was 
the Introduction which he wrote to his translation of 
the Microtegni of Galen. It was translated into 
Latin at an early date, but by whom is not known. 
In places the Latin is very obscure. The version 
from which the following translation has been made 
is that printed in the Articella published at Lyons 
in 1515. 

The Beginning of the Introduction of 
Joannitius to Medicine. 

Medicine is divided into two parts, namely 
theoretic and practical. And of these two the 
theoretic is further divided into three, that is to say, 
the consideration of the naturals, the non-naturals, 
and the contra naturals.^ From the consideration of 
these arises the knowledge of sickness, of health, and 
of the mean state, and their causes and significations ; 
of when the four humours increase in an abnormal 
manner, or of what may be the causation {occasio) or 
sio;nificance of sickness. 

^ See J^osa, fol. i verso, col. 2, ' Signa febris Tertiane.' 


Of the Naturals. 

The naturals are seven in number : elements, 
qualities {commix tioncs), humours (compositiones), 
members, energies, operations, and spirits. But 
some add to these four others : namely, age, colour, 
figure, and the distinction between male and female. 

The Elements. 

There are four elements : fire, air, water, and 
earth. Fire is hot and dry ; air is hot and moist ; 
water is cold and moist ; earth is cold and dry. 

The Qualities. 

There are nine qualities, eight unequal and one 
equal. Of the unequal, four are simple : namely, 
hot, cold, moist, and dry. From these arise four 
compound : namely, hot and moist, hot and dry, cold 
and moist, cold and dry. 

The equal is when the body is so disposed that it 
is in good condition and in a mean state, when it has 
a proper amount of all four. (' Equalis vero est 
quando cum moderatione corpus incolume ducitur.' ) 

Of the Humours {De H2imoribus). 

The humours [compositiones) are four in number: 
namely, blood, phlegm, reddish bile, and black bile. 
Blood is hot and moist, phlegm is cold and moist, 
reddish bile is hot and dry, black bile is cold and 

Of phlegm. There are five varieties of phlegm. 
There is the salt phlegm, which is hotter and drier 
than the rest and is tinged with the biliary humour. 
There is the sweet phlegm belonging to hotness and 
dampness, which is tinged with the sanguine humour. 
There is the acrid phlegm belonging to coldness and 
dryness, which is tinged with the melancholic humour. 


There is the glassy phlegm, which arises from great 
coldness and coagulation such as occurs in old people 
who are destitute of natural warmth. And there is 
another which is cold and moist ; it has no odour, 
but retains its own coldness and moistness. 

Of reddish bile. Reddish bile exists in five 
different fashions. There is reddish bile which is 
clear or pure and hot, both by nature and substance, 
of which the origin is from the liver. There is 
another which is straw-coloured, from which the 
origin is from the watery humour of the phlegm, and 
pure reddish bile, and therefore it is less hot. 
Another is vitelline. It is similar to the yolk of an 
^.?g' ^rid it has its origin from a mixture of coagulated 
phlegm and clear red bile, and this is less hot. 
Another one is green bile, like the green of a leek 
[prasiiwi), and it arises generally from the stomach 
or the liver ; and there is another which is green like 
verdigris, and which burns after the fashion of a 
poison, and its origin is from too much adtcstio, and it 
possesses its own proper colour and its own energies, 
both good and evil. 

Of black bile. Black bile exists in two different 
fashions. In one way it may be said to be natural 
to the dregs of the blood and any disturbance of the 
same, and it can be known from its black colour 
whether it flows out of the body from below or above, 
and its property is cold and dry. The other kind is 
altogether outside the course of nature, and its origin 
is from the adiistio of the choleric quality, and so it 
is rightly called black, and it is hotter and lighter, 
and having in itself a most deadly quality and a 
pernicious character. 

Of the various kinds of me^nbers. 

There are four kinds of members. Some of them 
are principal, and are as it were the substance and 


fundamentals of the body, as, for instance, the brain, 
the heart, the liver, and the testicles ; and there are 
others which do service to the aforesaid principals, 
such as the nerves, which minister to the brain, and 
the arteries, which minister to the heart, and the 
veins, which minister to the liver, and the spermatic 
vessels, which minister to the testicles, and bring the 
sperm to them. Some of the members, again, have 
their proper energy whence the members are ruled 
and in which their particular qualities consist. Such 
are the bones, and the cartilages, and the membranes 
which lie between the skin and the flesh and the 
muscles and the fat and the flesh. Others there are 
which work by the energy proper to them, but yet 
they obtain their origin and vigour from the principals 
and fundamentals. Such are the stomach, the 
kidneys, the intestines, and the muscles {lacei'-ti). 
For these by their own proper energy pick up the 
food and commute it, and they do their actions 
according to their nature, and they have other 
energies of their own arising from the principals and 
fundamentals, in which principals consist sense and 
life with voluntary motion. 

Of the number and division of the energies. 

The enerofies are divided into three. There is the 
animal energy and the spiritual and the natural. 

Of the natural energy. There is one natural 
energy which does service, and one to which service 
is done. But the natural energ-y to which service is 
done at one time generates, at another time nourishes, 
and at another feeds. 

But the energy which does service and is not done 
service to, in the same way desires, retains, and 
digests, and it expels those matters which are subject 
to the feeding energy, just as the feeding energy is 
subject to the nourishing energy. And the natural 


energy in its generating function is served by two 
others, one which transmits the food and the other 
which shapes it ; and these two differ, the one from 
the other, for the first changes the food and ministers 
to the generating energy, without the shaping, but 
the second does the same thing with shaping. And 
the operations of the informative energy are five — 
Assimilativa, Concava, Perforabilis, Aspera, Lenis. 

Of the Spiritual Energy. From the spiritual 
energy proceed two others, one the operative, and 
the other the result of the operation. The opera- 
tive energy is that which at one time dilates and at 
another contracts the heart and the arteries, and the 
results of this are as follows — Indignation, Victory, 
Domination, Astuteness, and Anxiety. 

Of the Animal Energy. The zodiacal energy 
embraces three things. There is one which arranges 
and puts together and classifies. The second is that 
which is moved by voluntary motion, and the third 
is that which is called sensible. From the first 
proceed Imagination in the front of the head. 
Cogitation or Reasoning in the brain, and Memory 
in the occipital region. The second moves the 
muscles [lacerti), by which the other • members are 
moved, that is to say by voluntary motion. And 
the sensible energy resides in sight, hearing, taste, 
touch, and smell. 

The operations. 

Operations are of two kinds : there are some each 
one of which individually performs that which is its 
own (function). Such, for instance, is appetite by 
means of heat and dryness ; Digestion by means of 
heat and moisture ; Retention by cold and dryness ; 
Expulsion by cold and moisture. There are also 
compound operations which are of a double nature : 
such are desire (deside7'iunt) and carrying off {depor- 


tatio). Desire is compounded of a double energy : 
the one longs for {appelit), and the other feels ; for 
the stomach is conscious of its own place (' stoma- 
chusenim suam mansionem sentit '). Carrying off is 
of two or more energies, one casts out, another attracts 
or feels, and a third longs for. 

The Spirits. 

The spirits are three in number : the first the 
natural spirit, having its origin from the liver ; the 
second the vital spirit, having its origin from the 
heart ; the third the animal spirit, having its origin 
from the brain. Of these three the first is diffused 
throughout the body by means of the veins which 
have no pulse ; the second is diffused throughout 
the body by the heart ; and the third is diffused 
throughout the body through the agency of the 
nerves by the brain. These are the matters which 
come under the heading of spirit in the seventh 
division of the seven naturals. 

Of the Ages. 

There are four ages ; namely, adolescence, the 
prime [jtiventus), decline {senectus), and decay 
{senium). The period of adolescence is hot and 
moist, during which the body increases and grows 
up to the twenty-fifth or thirtieth year. The prime 
follows which is hot and dry, during which the body 
remains in perfection without any diminution of 
bodily force, and it lasts from the thirty-fifth to 
the fortieth year. Next comes decline, which is cold 
and dry, and during this period the body begins to 
lessen and decrease, although the bodily force is not 
abated, and it lasts to the fiftieth or sixtieth year. 
Finally succeeds decay, which is cold and moist, with 
appearance of the phlegmatic humour, and during 


this period the bodily forces are abated, and the 
period ends with the end of Hfe. 

Of the colours of the skin and their Divisions. 

The colours of the skin are of two kinds ; namely, 
those due to internal causes and those due to 
external. And the internal causes again are two 
in number; namely, excess or equality of humours. 
From equality comes that tint which is composed 
of white and red ; from inequality proceed black, 
yellow, reddish {j'ubens), greyish (giaucus), and white. 
The reddish, black, and yellow set forth the ruling 
humour of the body : yellow by itself signifies reddish 
bile ; black by itself, black bile ; reddish by itself, 
abundance of blood. White and greyish signify an 
excess of coldness ruling the body ; greyish arises 
from black bile {melancholia) and white from phlegm. 

Certain colours arise from external circumstances, 
such as from cold among the Scots and from heat 
among the Ethiopians. And there are many others 
from other causes. 

There are also special or spiritual colours, due to 
fear, anger, grief, or other affections of the mind. 

Of the Colours of -the Hair. 
There are four colours of the hair — black, reddish, 
greyish, and white. Black is due to an excess of 
over-heated bile or blood ; reddish to a superfluity 
of a rather lower heat (caloris non adusti) — this is 
always the cause of reddish hair ; greyish arises from 
an excess of black bile, and white from a deficiency of 
the natural heat and the operation of putrid phlegm, 
and is therefore chiefly found in the aged. 

Of the Coats of the Eye. 
The eye has seven coats and three humours. 
The first coat is the retina, the second the secundine. 


the third the sclerotic, the fourth the spider's web 
{tela aranea), the fifth the uvea, the sixth the cornea, 
and the seventh the conjunctiva. And of the 
humours the first is the vitreous, the second the 
crvstalHne, and the third the albuQ^ineous which is in 
front of the uvea. 

Of the Qualities of the Body. 
The quahties of the body are five in number ; 
namely, excess or grossness ; thinness or tenuity ; 
' sinthesis ' (wasting), squalidity, and the mean state 
{eqiialitas). There are two kinds of grossness, the 
one consistinof in excess of flesh, and the other in fat. 
Excess of flesh arises from excess of heat and humours ; 
but fatness from cold and intense humidity ; loss of fat 
or thinness arises from heat and intense dryness. 
Sinthesis arises from cold and intense dryness ; squa- 
liditv either from cold and intense humiditv, or from 
an intensity of both together. And the miean state 
arises from a proper proportion of the humours. 
These are the appearances of the body. 

Of the Diference between Male and Female. 

The male differs from the female in that he is 
hotter and more dry ; she, on the contrary, is colder 
and more moist. 

The Beginning of the Treatise on the 
Non-naturals ; 

and first of the Changes of the Air. 

Changes of the air come about in five different 
ways ; from the seasons, from the rising and setting 
of the stars, from the winds, and from the different 
countries and their exhalations {fiviositas). 

Of the Seasons. 
There are four seasons ; namely, Spring, which is 
hot and moist ; Summer, which is hot and dry ; 


Autumn, which is cold and dry ; Winter, which is 
cold and moist. 

The nature of the air is also changed by the stars, 
for when the sun approaches a star or a star the sun, 
the air becomes hotter. But when they separate 
the coldness of the air is altered, viz., either increased 
or diminished. 

Of Ike Number and Properties of the Winds. 

There are four winds ; the East {subsola7ms\ the 
West, the North, and the South [austei^). And of 
these the nature of one is cold and dry and of another 
hot and moist. The two others are of an equal nature, 
for the East is hot and dry and the West is cold and 
moist. The South is slightly hotter and moister 
and the North colder and dryer. 

Of Varieties of Places and their Qualities. 

There are four varieties of places ; namely, height, 
depth, nearness to mountains or to the sea, and those 
particular qualities in which one district differs from 
another. Height produces cold and depth the 

The relation to mountains is as follows : if the 
mountains are to the south, the locality will be the 
cooler, for the mountains keep off the hot winds, and 
so the north winds seek it out with their cool breath. 
But if the mountains are to the north of the locality 
the reverse is the case. 

As regards relation to the sea : if the sea is on 
the south the locality will be hot and dry, if to the 
north it will be cold and dry. 

Soils differ among themselves. Stony land is cold 
and dry ; fat and heavy land is hot and moist ; clay 
lands are cold and moist. Exhalations from marshy 
land or other places where decay is going on also 
change the air and give rise to disease and pestilence. 


Of Exercise, 

Exercise has an effect on the body. To a mean 
amount it causes a mean amount of heat, i.e. exercise 
in moderation maintains the normal bodily heat. 
Violent exercise first of all heats the body, but after- 
wards cools and dries it. 

Rest also affects the body ; if excessive it increases 
cold and moisture, if of a normal amount it maintains 
the normal amount of coldness and moisture. 

Of Baths. 

Baths are either of fresh water or not fresh. 
Fresh-water baths soften the body, and if hot they 
warm it, but if cold they cool it. But a fresh-water 
bath does not dry up the body. Baths of salt or 
bitter or sulphurous waters heat and dry up the body. 
Aluminous or lime {gipsea) baths cool and dry up 
the body. 

Of Foods. 

Foods are of two kinds. Good food is that which 
brings about a good humour, and bad food is that 
which bringrs about an evil humour. And that which 
produces a good humour is that which generates 
good blood ; namely, that which is in the mean 
state as regards quality {commixtio) and working. 
Such is clean fresh, fermented bread, and the flesh 
of lamb or kid. Bad food brings about the contrary 
state, and such is old and bran {opirus) bread, or the 
flesh of old beeves or goats. Foods producing 
good or evil humours may also be heavy or light. 
Of the first kind are pork and beef, of the second 
chicken or fish. And of these the flesh of the middle- 
sized and more active kinds is better than that of 
the fatter and scaly varieties. 

Certain kinds of vegetables produce evil humours ; 
for instance, nasturtium, mustard, and garlic beget 

1S02 K 


reddish bile. Lentils, cabbage, and the meat of old 
goats or beeves produce black bile. Pork, lamb, 
purslain, and attriplex beget phlegm. Heavy foods 
produce phlegm and black bile, light food produces 
reddish bile, and either of these is evil. 

Of Drinks. 

Drinks are of three kinds : firstly, drink which is 
nothing but drink, as water ; secondly, drink which 
is both drink and food, as wine ; and thirdly, drink 
partaking of the nature of both of these, called potto, 
which is given to counteract the evil of some disease. 
Such are mellicratum, mulsa, and conditum. 

The use of the food is to restore the wholeness of 
the body, the use of the drink is to distribute the 
food throughout the body. But that kind of drink 
which we have above called polio converts the nature 
of the body to itself (' Sed illius potus quern potioni 
diximus pertinere, corporis naturam ad se convertit.') 

Of Sleep. 

Sleep changes the nature of the body in that it 
cools it exteriorly and warms it interiorly. If it be 
prolonged it cools and moistens the body. 

Waking also changes the body, for it warms it 
exteriorly, while interiorly it cools and dries it. 

Of Coitus. 

' Coitus hoc prestat corpori ; siccat corpus et 
minuit naturalem virtutem, ideoque infrigidat, mul- 
titotiens vero ex multa concussione corpus calefacit.' 

Of Affections {Accidentibus) of the Mind. 

Sundry affections of the mind produce an effect 
within the body, such as those which bring the 
natural heat from the interior of the body to the 
outer parts or the surface of the skin. Sometimes 


this happens suddenly, as with anger ; sometimes 
gently and slowly, as with delight and joy. Some 
affections, again, withdraw the natural heat and 
conceal it either suddenly, as with fear and terror, 
or again gradually, as poverty. And again some 
affections disturb the natural energy both internal 
and external, as, for instance, grief. 

Of the Contra Naturals. 

There are three contra naturals ; namely, disease, 
the cause of disease, and the concomitants or sequels 
of disease. Disease is that which primarily injures 
the body, without the aid of any intermediary, as, for 
instance, heat in continued {siiccedente) fever. 

Of Fevers. 

Fever is unnatural heat, i. e. heat which overpasses 
the normal course of nature. And it proceeds from 
the heart into the arteries, and is harmful by its own 

And of it there are three kinds : the first in the 
spirit {anima), which is called ephemeral ; the second 
arises from the humours which putrefy, and which is 
therefore called putrid ; and the third affects for ill 
the solid portions of the body, and this is called 
ethic (i. e. hectic). 

Of these three the ephemeral variety arises from 
non-essential causes {ab accidenti occasione). Putrid 
fever arises from putrid matters, and these are 
simple and uncombined, and they are four in number. 

The first is that which arises from putridity of the 
blood and burns up both the interior and exterior of 
the body ; such, for instance, is continued fever 

The second is that which arises from putridity of 
reddish bile; such, for instance, is tertian fever 

K 2 


The third arises from putridity of phlegm ; such, 
for instance, is quotidian fever. 

And the fourth arises from putridity of black bile ; 
this attacks the sick man after an interval of two days, 
and it is called quartan. 

In addition there are three kinds of fevers occurring 
from putridity. First there is the fever which lessens 
day by day ; such, for instance, as that called peraug- 
vtastictis, i. e. decreasing (jrapaKfiaaTiKo?). 

Secondly, that which increases until it departs ; 
such as that called augmasticus {aKiiacrrLKoi). 

Thirdly, that which neither decreases nor increases 
until it again {iterimt) departs ; such, for instance, as 
that called homothenus {b\iorovos). 

Continued fever arising from putridity in the veins 
begins to decline by departing from out the veins 
into other parts of the body. 

Goose-skin or shivering {horripilatid) occurs in 
fevers from an infusion of putrid matter into the 
sensitive members, which gnaws {niorderis) and makes 
them cold. 

And, therefore, goose-skin occurs in these fevers 
which are characterized by remissions {anesim) or 
variations [interpolaiiojtem), for the putrid matters 
are outside the veins. 

0/ Swellings. 

There are four simple kinds of swellings ; those 
which arise from the blood and are called phlegmons ; 
those which arise from reddish bile and are called 
erysipelas ; those which arise from coagulated phlegm 
and are called undimiae'^ or cimiae, that is to say 
tumour ; and finally, those which arise from black 
bile and are called cancerous phlegmons. 

^ Undimiae is a corruption of oUrjiia. An English translation of 
Lanfranc, circa 1400, has 'vdemia'. 


The signs of a swelling arising from the blood are 
these : redness, a hard pulse, pain, heat, swelling. 

And the signs of those arising from bile are these : 
heat, a reddish yellow colour, great pain of a darting- 
character, and rapid increase. And the signs of those 
arising from phlegm are these ; a white colour and 
softness, so that if the finger be pressed thereon it 
makes an impression ; moreover it is painless. 

And the signs of those arising from black bile are 
these : great hardness, a black colour, and absence of 

Of the Natural Condilion {Res Naiiu alls) in the 

Human Body. 

In the human body, if each and singular natural 
condition maintains its proper quality, such a condition 
makes for health. If any one of them fails, either 
sickness follows or else the neutral state. 

Of the Classes of Sickness. 

There are three classes of sickness : (i) the similar, 
(2) the official, and (3) the universal. 

An aegritndo consiniilis is one affecting the similar 
members (tissues), and they receive names of like 
nature to the suffering; such, for instance, as an aching 
(head). (' Est quidem egritudo consimilis similibus 
membris contingens quae similia sortiuntur vocabula 
cum eadem passione ; ut est caput dolens.') 

And an aegritudo officialis is one which occurs in 
special members, such as the feet, the hands, the 
tongue, or the teeth. This takes its. name from 
the accompanying infirmity {ex accidejiti infirmitate), 
such as podagra in the foot or chiragra in the hand. 
Or again, it may take the name from the member 
in which they occur {ex membris qiiibiis accidunt), as 
podagra, chiragra. 

(This passage is very obscure, but it seems to 


mean that an aegritudo consimilis receives its name 
from the kind of suffering, as, for instance, aching, 
burning, and the Hke. The aegritudo officialis is so 
called from the organ or member which it affects. 
Thus ' toothache ' is an aegritudo officialis, while 
aching, burning, or darting pains in the head would 
be aegritudines consimiks) 

And finally an aegritudo wiiversalis is one which 
is associated with the two aforesaid, as separation of 
the limbs and paralysis. 

Of Diseases in the Similar Members. 

Diseases of the similar parts are eight in number, 
four simple, and four compound. 

The simple arise solely from heat, from moisture, 
from cold, or from dryness. 

And these four may be combined so as to be 
compound, such as cold and moist, cold and dry, hot 
and moist, hot and dry. 

Each of the eight kinds may be of two varieties, for 
either it is of a simple quality {ex qualitate simplici), 
or it is combined with one or other of the humours. 

For exam.ple, a disease of a simple quality is one 
affecting the solid members, such as the Greeks call 
ethica (i. e. hectic). 

A hot disease arising from combination with some 
humour is a putrid fever, as has been said above. 

Chilling {aigor) due to very cold air or snow is 
a simple cold disease without admixture of any 
humour. But a cold disease, with an admixture of 
humour, is paralysis, either complete or partial. 

The mark of a moist disease is that it has an 
.idmixture of humour ; for instance a cold or ulcer- 
ated (vacutmi) wound ; or again a very foetid wound 
accompanied by wasting of the body, as, for instance, 
the puffed- up flesh of dropsical persons, which flesh 
is inactive and in an unprofitable condition (' quemad- 


modum inflata caro hydropicorum vacuo squalore 
terpens '). 

A moist disease is one which attracts to itself 
foreign humours, as, for instance, dropsy. 

A dry disease with an admixture of humour is, for 
instance, a hard and dry cancer. 

Of Diseases in the Official Members. 

Diseases occurring in the official members are four 
in kind : they concern shape, size, number, and 

(i) As to shape. Abnormalities of this are un- 
becomingness of a member, e.g. {a) a very long 
head ; {b) absence of the normal concavity, as when 
the hollow of the foot or hand is filled up with flesh ; 
ic) variations in the size of canals, as stricture or 
dilatation ; {d) roughness, as of the throat or of the 
trachea and bronchi ; {e) smoothness, as of the w^omb 
or the stomach. 

(2) As to size. Abnormalities of size arise from 
overplus of sperm, owing to which the member grows 
to a greater size than it should do. And so we 
sometimes see a very large head or tongue. 

Also a member may be unbecomingly small, as 
we sometimes see in the case of the head, the 
stomach, or the liver. 

(3) As to number. Abnormalities of this kind 
occur either by augmentation or diminution. And 
those due to augmentation are either according to the 
course of nature or outside it. Of the first kind 
are extra fingers ; of the second are round worms 
{/u7ndrici), thread worms {ascarides\ warts, and 
acrocordines, that is to say large fleshy growths or 
large spreading warts or fistulae [pori). 

Those due to diminution are either universal or 
particular. Of the first kind is absence of all the 
fingers ; of the second kind absence of one finger. 


(4) As to position. Abnormalities of position are 
due either to a removal of the member from its 
proper place or to some defect in its relation to 
neighbouring parts. Such abnormalities we see in 
the fingers and the lips. The fingers may be double 
{con^lutinantMr) , or sN^hh&d {vel adherent), or the lips 
may be separated and not joined (? harelip). 

Separation in a member which ought to be whole 
happens both in similar members and in official 
members. The similar members are the bones, the 
nerves, the flesh, the veins, the muscles, and the 

When separation occurs in a bone it is termed 
a fracture ; when occurring in the flesh (if recent) it 
is termed a wound. But if the injury is of old 
standing it is not called simply a wound, but a putrid 

Separation in veins, nerves, or arteries is some- 
times called by one name and sometimes by another. 

If the injury occurs in the middle of a muscle it is 
called a contusion or a bruise {contritio). 

If it occurs in the skin, it is termed an excoriation ; 
but this, if it be of long standing, may become a 
putrid wound. 

Separation occurring in the official members may 
be lasting, as, for instance, loss of the hand or foot. 

Of the Qualities of the Body. 

The qualities of the body are three in number ; 
namely, health, sickness, and the mean state. 

Health is that condition in which the temperament 
of the body and the seven naturals are working ac- 
cording to the course of nature. 

Sickness is defect in temperament outside the 
course of nature, and injuring nature, whence arises 
an efficient condition of harm which may be felt 
(' unde fit laesionis effectus sensibilis '). The mean 


state is that which is neither health nor disease. 
And there are three kinds of this mean state: (a) when 
health and disease co-exist in the same body; which 
may happen in different members, as in the blind or 
the lame ; (d) in the bodies of the aged, in whom no 
one member remains that is not in evil case or 
suffers ; {c) in those who are well at one season and 
sick at another. For instance, persons of a cold 
nature are sick in the winter and well in the summer ; 
and those of a moist nature are sick in childhood, 
but well in youth and old age. Those of a dry 
nature are well in childhood, but sick in youth and 
old aore. 

Health, sickness, and the mean state are evident 
in three ways ; (1) in the body in which any one of 
them occurs ; (2) in the cause which produces, which 
governs, and which preserves them ; (3) in their in- 
dicating signs. 

Of the Causes {Occasiones). 

Causes are of two kinds, either natural or outside 
the course of nature. 

Natural causes either produce health or preserve it. 

And the preservative causes pertain to the main- 
tenance of health, but the productive causes to the 
expulsion of sickness. 

The non-natural causes pertain to sickness or to 
the mean state. Causes of sickness produce sickness, 
and they also maintain it. And that which pertains 
neither to health nor to sickness brings about and 
maintains the mean state. 

Of the Causes of Health and of Sickness. 

The causes which have a relation to health and 
sickness are six in number,^ and of these the first is 

^ i.e. the six non-naturals. 


the air which surrounds the body. Then follow 
food and drink, exercise and rest, sleep and waking, 
fasting and fullness, and finally affections of the mind. 
All these, if in moderation as to quantity, quality, 
time, function, and order, tend to preserve health. 
But if in excess in one of these matters they tend 
to produce sickness and to maintain it. The causes 
which bring about sickness are of three kinds ; those 
which are called primitive and affect the body exter- 
nally, such as cold and heat ; those which are ac- 
cidental and act within the body, such as fullness 
or fasting ; and those which are called conjoint, 
because when they are present disease is present, 
and vice versa, such as, for instance, putridity in 

Of the Varieties of Sickness. 

Sickness may again be classified under two heads ; 
namely, common and proper. 

Those under the first heading occur either acciden- 
tally, such as striking, burning, biting, catching in 
a trap (?) {deceptio), or other harmful effects. 

Or they occur of necessity ; for example, those 
just mentioned as having a relation to health and 
sickness. And these are really proper sicknesses 
and they occur in the similar members, where they 
maintain sickness, or in the official members, and in 
cases of permanent separation, i.e. in loss of the hand 
or foot. 

Of the Diseases A rising from Heat. 

Disease may arise from heat in five different ways. 

Firstly, from disturbance of the spirits or of the 
body. An example of the former is anger, of the 
latter, fatigue, or sexual excitement [superbia). 

Secondly, the direct action and obvious effects of 
heat, such as hypanthasis, i.e. sunburn or sunstroke. 


Thirdly, heating of the body by some substance 
which has an accompanying faculty of heat, such as 
the use of 'acrumina ' (e. g. onions and garlic). 

Fourthly, from the shutting up of the pores, as 
from cold in winter. 

Fifthly, from putridity of the humours, as in fevers. 

Of the Diseases A rising from Cold. 

Disease may arise from cold in eight different ways. 

Firstly, from the direct action and visible effect of 
cold, such as from the coldness of snow. 

Secondly, from cold drugs such as opium, which 
strongly affect the human body. 

Thirdly, from excess of food, which fills up the 
body and extinguishes the natural heat. 

Fourthly, from deprivation of food, which also 
extinguishes the natural heat. 

Fifthly, from excess of cold or of cold humours, 
which block up the pores, so that the natural heat 
is lessened. 

Sixthly, from purging and opening of the body, so 
that the natural heat is purged away and evacuated. 

Seventhly, from violent exercise with profuse 
sweating, whereby the body is weakened. 

Eighthly, from sleep and plenty of leisure {occasione 

Of the Diseases Arising from Dryiiess. 

Disease may arise from dryness in four different 

Firstly, from the direct action and visible effect of 
dryness, such as the dryness of poison. 

Secondly, from the presence in the body of some 
dry harsh substance, as, for instance, vinegar, salt, or 

Thirdly, from deficiency of food or drink. 

Fourthly, from over-exercise. 


Of the causes of Diseases Arising from Moisture. 

Disease may arise from moisture in four different 

Firstly, from the direct action and visible effect of 
moisture, such as a bath. 

Secondly, from the presence in the body of some 
moist substance, such as fresh fish. 

Thirdly, from excess of food or drink. 

Fourthly, from sleep and leisure. 

Of the Modes of Disease. 

There are four ways in which disease may occur 
from an abnormal motion of some humour to a 
weakly part. 

Firstly, vigour of the impelling, and weakness of 
the receiving, member. 

Secondly, an abundance of humour. 

Thirdly, weakness of the nutrient energy. 

Fourthly, an abnormal largeness of the pores. 

Of the Evil Quality {' Malitia') of Sickness. 

The evil quality of sickness attacks and resides in 
a similar member in five different ways. 

Firstly, in the uterus. 

Secondly, at the time of birth. 

Thirdly, from the infant being too tightly swaddled. 

Fourthly, from defective nutrition. 

Fifthly, from any sickness which may occur at the 
aforesaid times or afterwards. 

Sickness of the embryo or foetus arises from a 
defect in the sperm, which may be either too thick 
and rich or two thin and watery. 

If the child be not born rightly it may be affected 
for ill, as, for instance, if it be delivered looking 
upwards ( } face presentation) or with the knees bent 


( ? breech presentation). If it be too tightly swaddled 
it may be injured by being doubled up {dzcpiicatus 

Or it may be defectively nourished by not being 
able to suck or to take milk. 

And at any of these seasons or afterwards sickness 
may occur in a consimilar member by incision of any 
tendon or nerve {iiervtts). 

Or some accident may occur, or a wound or a 
swelling {apostemci). 

Of Sicknesses of the Consimilar Members. 

Sickness may affect a similar member in seven 
different ways. 

Firstly, from a midwife who holds the child 

Secondly, if the child be allowed to walk too soon. 

Thirdly, from an ignorant physician if he puts to 
right, or bandages, deformed [contrafacta) or bruised 
limbs unskilfully. 

Fourthly, from the patient himself, should he move 
a broken or injured limb, after being put up by the 
surgeon, before it has properly healed or set. 

Fifthly, from fracture, as, for instance, when the hip 
is twisted above the muscle of the hip-bone which is 
on the femur ( ' ut si super musculum vertebri quod 
in femore est contorqueatur coxa').^ 

Sixthly, from a blow as, for instance, if the nose be 
driven in and a ' chimus ' is the result. 

Seventhly, from some evil humour, as is the case 
in lepers, or from some deficiency of the humour 
as is the case of those who are phthisical (' humoris 
accidentis ptisicis '). 

^ This passage would seem to be a reference to some dis- 
location at the hip-joint. 


Of Constriction or Dilatation of the Pores : 
Of Smoothness and of Roughness. 

Constriction of the pores happens in three ways. 
Firstly, from uncomplicated constriction ; secondly, 
from fleshiness ; thirdly, from narrowing {coartatione). 

Uncomplicated constriction is caused {a) by excess 
of the retentive energy ; or {^) by deficiency of the 
expulsive energy ; or \c) by excessive cold ; or {d) by 
tight constriction of any part of a limb, as often 
happens from a tight bandage ; or {e) from excess of 

Secondly, fleshiness contracts the pores, as in the 
case of swellings {apostema) or in the seat of an old 
wound (? scar tissue). 

Thirdly, narrowing contracts the pores, when 
anything is deposited in them such as a humour, or 
a stone, or a blood clot, or again anything which lies 
hid therein, such as proud flesh or ' scabies '. 

Dilation of the pores may be due to four causes. 

Firstly, excess of the expulsive energy ; secondly, 
to deficiency of the retentive energy ; thirdly, to 
excess of the colours of humours. Fourthly, to 
aperient medicines. 

Smoothness may occur after two fashions ; internal 
and external. 

If internal it may be due to liquefied and viscous 
humours, if external to ointments. 

Finally, roughness may occur after two fashions : 
internal, due to excess of sharp humour, or external 
from smoke and dust. 

Of Excess of the Number of Members. 

Excess of the number of members happens in two 
ways. If natural, it is due to an excess of the natural 
and normal humour, or from excess of the informative 


If outside the course of nature it is due to an 
unnatural and abnormal humour, or to an excess or 
deficiency of energy. 

Of Dimhiution in the Number of the Members. 

In like manner, diminution of the number of the 
members happens in two ways, internal and external. 

If internal it may be due to diminution of humours. 
If external, to burning, or to cold, or to putridity, or 
to cutting. 

Putridity is due either to some poisonous draught 
which causes mortification orbrings about putrefaction 
('ex potione mortificante, aut putredinem faciente'). 
or to constriction and retention of the humour which 
is thereby broken down. 

Of the Size of the M&mbers. 

Bigness of the members occurs in three ways. 
Firstly, from an excess of the humours ; secondly, 
from an excess of the (formative) energy ; thirdly, 
from an admixture of the two. 

Smallness also occurs in three ways. Firstly, from 
deficiency of the energy ; secondly, from cutting 
{incisione) ; thirdly, from burning by fire or from 
excessive cold. 

Of the Displacement of a Member. 

Commotio membri de suo loco duobus modis fit, 
Aut ex commotione voluntaria, aut ex humore vicino 
equitanti dissolventi membrum et lubricum facienti. 

Membrum vel os egreditur e sua -junctura et 
mutatur duobus modis similiter. Aut ex junctura in 
qua non convenit separatio, aut ex separatione ubi 
non convenit junctura. Si ex conjunctione hoc fuerit 
sine separatione, aut erit ex humore acuto patientis, 
aut ex accidenti vulnere, aut spasmo. 

Si vero fuerit ex separatione ubi non convenit 


conjunctio, aut ex grosso humore, aut ex accidenti 
vulnere, aut ex spasmo.^ 

Of Separation of Parts Normally Joined. 

Separation of parts normally joined is due to either 
an intrinsic or to an extrinsic cause. 

Intrinsic causes are the invasion of {a) an acute 
humour ; and {U) a ventosity, '^ which distends and 
weakens the parts. 

Extrinsic causes are cutting, fracture, rupture due 
to muscular effort {exercitium nimiimi), sword cuts, 
anything which stretches {distendit), as a rope, or 
which bruises, as a stone. 

Of the Kinds and Number of Symptoms. 

There are three genera of symptoms, which refer 
respectively to health, to sickness, and to the mean 

And each genus is divided into two species ; 
namely, those which have to do with the official 
members, and those which have to do with the 
similar members. 

Again, the symptoms of similar members are of 
two kinds, i. e. substantial and accidental. 

The substantial are heat, cold, dryness, and 
moisture. The accidental are those which show 
their significance either by touch, as hardness or 

^ I have not translated this passage from sheer inability to do 
so ; it apparently refers to the difference between a fracture and 
a dislocation, junctura sometimes meaning a joint in the ana- 
tomical sense, and sometimes a joint in the carpenter's sense, 
i. e. continuity of tissue. Membrum, too, seems first to mean an 
organ and afterwards a limb. So that the beginning of the second 
paragraph would mean something like the following : ' A limb or 
a bone can be moved from its continuity in two ways, either at 
a joint, in which case there is no fracture, or by a fracture where 
there is no joint.' 

"^ Cf. the old term ' Spina Ventosa '. 


softness ; or by sight, as colour. Some, again, are 
obvious by action of the energies, as, for instance, 
when the functions are well and fully performed. 

Of Symptoms in the Official Members. 

Symptoms in the official members are likewise 
divided into substantial and accidental. The first 
are four in number, namely, number, position, ars 
( ? function), modus (? arrangement). The accidental 
are likewise four : namely, good, bad, perfect, im- 

Of the Genera of Sy^nptoms. 

There are three genera of symptoms : (i) those 
which show what has happened, and they are called 
cognitive or agnitive. For instance, when we find 
the body wet M^e know that sweating has gone before. 
(2) Those which show what is present and are called 
by Galen demonstrative, as, for instance, when we 
find a large and quick pulse we understand that fever 
is present. (3) Those which show what will happen 
and the perception of those precedes the event, as, 
for instance, if we see the lower lip tremble we judge 
that vomiting will occur, which after it has happened 
is called precessio sigmficativa. 

But between symptoms and signs [accidentia) there 
is a difference, and there is a gradually widening 
division between them. If you carefully examine 
each one of the differences respectively it will have 
one particular signification ; but some things which 
are signs to the patient are symptoms to the 

Of Signs and their Nmnber. 

Significant signs are of three kinds : a change in 
the operative energy, as, for instance, indigestion ; 
a change in bodily quality, as, for instance, jaundice ; 
a change in excretion, as, for instance, black urine. 



Of Change in the Operative Energy. 

Changes in the operative energy are three in kind : 
total, as indigestion ; or partial, as obscurity of the 
eyes, or slow digestion ; or from one quality to 
another, as when good digestion is changed into 
a turbid or acid digestion, or when specks like flies 
or chips {ligna) appear before the eyes, or partial 
obscurity of the sight. 

Of Changes in Qitality. 

Changes in quality are four in kind. Those 
obvious to sight, as jaundice, or morphea,^ or black 
tongue ; or known by smell, as foetid breath or sweat 
or polypus ; or again those which are known by 
taste, as salt, bitter and acid ; and finally those which 
are known by touch, as hard and soft. 

Of Excretions. 

There is a* double significance in the excretions. 
For some come forth with noise, such as eructations 
from themoudi, rumbling in the iritestines, and wind 
from the anus. 

And those which come forth without sound may 
be abnormal in three different ways : in quantity, or 
quality, or in both. An example of the first is 
lientery, of the second black urine, of the third a flux 
of blood. 

Of Alterations in Members. 

Alterations in members are primarily divided 
into two classes, namely intrinsic and extrinsic. 

Intrinsic changes are six in number : {a) change 
of the operative energy of a member ; {U) changes in 
the excretions ; {c) changes from pain in the neigh- 

^ ' Morphea is a spice of lepre that sitt in the skyn.' Lanfranc, 
Science of Cirurgie, EngUsh translation about 1380, E.E.T.S., 
Orig. Series, No. 102. 


bourhood of a member ; [d) changes from pain in the 
member itself; {e) changes by abnormal mobility; 
{/) changes gathered from the opinion of the patient. 
And intrinsic changes are three in number : {a) those 
obvious to the sight, as whiteness or blackness ; 
{b) those obvious to the touch, as hardness or soft- 
ness, heat or cold ; [c] those which are obvious to 
both senses, as greatness or smallness, increase or 

Of the Causes of Sickness. 

The causes of sickness are three in number : 
Firstly, a change of nature ; secondly, habitudo 
inconveniens of an official member ; thirdly, a separa- 
tion of continuity. 

Of the Operation of Medicine. 

The operation of a medicine has the following 
threefold effect : it preserves health, after its many 
different kinds {secundum 7mcltitudine77i suani) ; or, 
out of illness it produces health ; or finally it acts in 
the contrary fashion. 

Of the Regimen of Health. 

The regimen of health is of three kinds according 
as it deals with those prone to illness, those just 
beginning to be ill, and weakly persons. 

The first classes are treated by proper regulation 
of the aforesaid six things, i. e. the non-naturals. 

Those in the second class are treated in two ways; 
first, by removal of the excess of humour {chimus) ; 
secondly, by repairing any defect in nature and by 
counselling adherence to the proper observance of 
the non-naturals. 

' Weakly persons * are infants, old persons, and 

L 2 


Of the Divisions of Medicine in General. 

All Medicine comes under one of two heads, 
general or particular. 

General Medicine concerns itself with the right 
ordering of the non-naturals. 

Particular Medicine has three divisions, according 
to whether it is concerned with the similar members, 
the official members, or with solution of continuity. 

Abnormal chano^es in the similar members are 
treated by being brought back to their original con- 
dition or state, and retained therein by bandaging. 

If hollow organs (? channels) are over-dilated we 
bring them back to their proper size and keep at rest. 
If they are too small we do the contrary. {' Concava 
si preter modum ampliata fuerint, ad sui modum 
constrlngimus et quietem inducimus. Si minus, 
contrarium.' ^) 

If there be defect of the retentive energy, we 
mollify the place with fomentations and cataplasms. 

If there be defect of the expulsive energy we use 
diaphoretics and carminatives {confortativa). 

If the cause be of a styptic nature use a softening 
remedy ; if dry, a moist one ; if the disease arises 
from constriction apply some remedy which will 
break it down. 

In cases where there is a change from the natural 
order of things, we restore them to their proper 
working. If, for instance, there is an apostema, we 
cure it by bringing it to a head. If the trouble 
arises from an adhesion {iiaturali junciurd) we either 
use an aperient medicament or else we alter it by 
surgery. If there is some new growth we take it 

^ The following passage is omitted, as the Latin is very 
obscure. It is possibly an alternative translation of the foregoing 
clause, which begins Concava. ' In largis autem similiter addito 
contrario cause, unde vitium acciderit, foramina strictiora suo 
modo facimus.' 


away ; if roughness be present we use smoothness, 
and vice versa. 

Of the Re7noval of Overgj'oivth. 

Overgrowth we remove either in part, as in the 
case of scrofulous swelling, or totally, as in the case 
of cancer. 

' Separatio ' we cure as follows : if from overplus 
of blood, we take it away (? bleed) at all ages. ' Si 
ex spermate in pueritia tantum sanamus.' 

If a limb be too small we increase its size by 
exercise and fomentation, if too big we lessen it by 
rest and bandaging. 

Of Displace7neiit of Members. 

Displaced members are restored to their normal 
condition in two ways : (i) by joining what is separ- 
ated ; (2) by separating what is joined. 

In the former case there are four essentials : {a) 
to join the separated parts ; {f) to keep the joined 
parts in place ; {c) to prevent displacement occurring 
again ; and {d) to maintain the seat of injury in a 
wholesome condition (' naturam loci custodire '). 

Of the Sufficiency and Division of Mediciiie. 

The practice of medicine deals with the right 
ordering of the non-naturals, with giving of drugs 
[potio), and with surgery. Drugs are administered 
internally by the mouth, by the ears, by the nose, 
by the anus, and by the vulva. Externally by means 
of poultices, plasters, and stupes. 

Medicines administered internally act in three 
ways ; they loosen or they bind, or they bring about 
an alteration in quality, as does cold water in 
a fever. 

Sometimes they act in four ways : they reduce 
over-excess ; or they supply deficiency, as, for 


instance, flesh or blood when administered ; or they 
bind what is loose, as does a styptic ; or they bring 
about an alteration in quality, as does water in fever. 

Of Surgery. 

Surgery deals with two tissues, i.e. with the flesh 
and with the bones. 

When dealing with the former it cuts, sews, and 
? heals {coqtiere). 

When dealing with the latter it consolidates, 
unites, and scrapes. 

Of the Judging of Drugs (Species). 
The right judging of drugs takes into consideration 
five different matters : quality, quantity, season (of 
gathering), arrangement ; and the question of 
whether they be good or bad. 

The end of the Book of the Introduction of Joannitius 
and Praise be to God, 



Gaddesden was evidently acquainted with, or had 
even read, the writings of a large number of his 
predecessors. Many, however, of the authors whom 
he mentions are unidentifiable, and again the writings 
of some have become confused owing to the fact 
that there were two or more of the same name. In 
some cases he quotes both the name of the author 
and that of the work, in others only the name of the 
author, and in one case at least simply the name of 
the treatise, or rather its opening words. This last 


method of reference was common in the Middle 
Ages, and has survived in the Western Church for 
the naming of Sundays from the first words of the 
Introit, e. g. Rorate Coeli (fourth Sunday in Advent), 
or again Laetare (fourth Sunday in Lent). 

So Gaddesden, fol. 48 rect., col. 2, says : ' Certissi- 
mum est remedium dicit Alguasinus et Circainstans.' 
The latter authority is Matthew Platearius the 
younger, Ji. 1 1 30-50, who wrote De Simplici 
Medicina Liber, a treatise which began with the 
words ' Circa instans '. 

In the preparation of the short notes upon the 
various authors I have been most kindly and help- 
fully aided by Dr. Payne. Some of the writers 
quoted have, however, surpassed even his knowledge 
to identify. The order of the names is that in which 
they first occur. 

Authors Quoted or Referred to by Gaddesden. 

Haly (Ben Rodoan). Commentary on the Tegni 
{rexyr]) of Galen, otherwise Microtegni or Ars 
Parva. Number of times quoted, 98. 

Haly, whose full name was Abul-hassan ' Ali ben 
Ridhwan ben 'Ali ben J a far, was born at Ghizeh 
about A. D. 980. He was physician to the Khalif al 
Hakim, and wrote a number of medical works as 
well as commentaries upon Hippocrates and Galen. 
The Arabic translation of Galen was made by 
Hunain, born a. d. 809, and his nephew Hubaish. 
The translator of the Tegni into Latin was Con- 
stantine the African, about a. d. 1070 ; of the 
commentary by Haly, Gerard of Cremona, in the 
12th century. 

Avicenna. Canon, Number of times quoted, 474. 

Avicenna, otherwise Abu 'Ali al-Husain ben Ab- 
dallah ibn Sina, was born in Bokhara in a. d. 978 and 
died in 1036. He was not only a celebrated physician, 


but also an astronomer and a man of affairs, holdino- 
a viziership, and was generally accorded the titles of 
Rais and Shaikh. His great medical work was the 
Canon, which, together with the works of Galen and 
Hippocrates. practically dominated mediaeval medical 
thought. It was divided into five parts; namely, a 
general view of medicine, materia medica, particular 
diseases, general diseases, pharmacopoeia. The Latin 
translation was made by Gerard of Cremona. 


Practica ; Pantegni. Number of times quoted, 40. 
Constantine the African, whom Leclerc ^ calls ' un 
6tre amphibia ', was, according to Petrus Diaconus, 
born at Carthage (? Tunis), and studied in Baghdad, 
Cairo, and India. About the year 1072 began the 
second half of his life, for he arrived at Salerno and 
very shortly afterwards settled at Monte Cassino. In 
the retirement of the great Benedictine house he wrote 
various medical works. Some of these were frankly 
acknowledged as translations, while others were 
issued as originals, although really translations. 
Among the latter was the treatise called Pantegni or 
Practica, for the two are the same work. It was a 
translation of an Arabic work, which, according to 
the latest researches, is the Maleki or Liber Regalis 
of Haly Abbas (i. e. 'Ali ibn al-Abbas), though it was 
ascribed in the Middle Ages to Isaac Judaeus (i.e. 
Isaac Israeli). Among the acknowledged transla- 
tions of Constantine were those of the Tegni, of the 
Aphorisms of Hippocrates with the commentary of 
Galen (according to Constantine the first work of 
Galen to be translated into Latin), and the Liber 
Febritnn and De Urinis of Isaac Israeli. 

' Lucien Leclerc, Histoire de la Medecine Arabe, Paris, 2 vols., 
E. Leroux, 1876. This Leclerc must not be confounded with 
Daniel Leclerc, a seventeenth-century writer who wrote a History 
of Medicine, considered a standard work. 


See also Viaticum in the note on Gerard of 

Aristotle. De Morbo ; De Animalibus ; The 
Letter to Alexander. Number of times quoted, 15. 

Aristotle was born in 384 b. c, his father being an 
eminent physician by name Nicomachus. Numerous 
Arabic translations of Aristotle's works were made in 
the ninth century, and Latin translations were made 
in Europe in the eleventh, twelfth, and thirteenth 
centuries. Michael Scot, about whose name so 
many legends have gathered, translated the De 
Animalibus, probably at Toledo, about 1209.^ 

The Letter to Alexa7ider is now regarded as 
spurious, and there is no work of Aristotle known in 
Greek with a title corresponding to De Morbo. 

Galen. Works quoted : De Ingenio Saniiatis ; 
De Lrisibus ; De Dinmnidiis ; ApJiorism. 
Hippocrat. ; Pro;;^nostica, i. e. Commentary on ; De 
Simp lici Med. ; De Sinocho ; De Morbo et Accidenti ; 
De I nterioi-ibiis membris ; De Mala Complexione ; 
Regimen Acutorujn ; Megrateg?ii (sic) ; De Juvamen- 
tis membrorimi ; Tegni with Haly's commentary; 
De Passionibus ; Viaticum, fol. 70 rect., col. 2 at 
foot. Number of times quoted, 417. 

Claudius Galen, born in Pergamus about a. d. 130, 
studied in Greece and Egypt, and came to Rome at 
the age of thirty-four. He was held in great 
esteem by Marcus Aurelius. His medical writings 
were much prized by the Arabs, and numerous 
translations were made into Arabic, mainly by 
Hunain and Hubaish. The principal translators of 
his works into Latin were Constantine and Gerard of 

Of the works mentioned by Gaddesden Dr. J. F. 
Payne writes : ' The De Ingemo Sanitatis is another 
name for the translation from the Arabic of Galen's 
^ Wood Brown, Life and Legend of Michael Scot, 1897. 


Methodus Medendi, not the book called De Sanitate 
Ttienda, as is sometimes supposed. I have verified 
several quotations or references in other books, and 
find that the Methodus Medendi is meant. 

' I suppose that the word ingeniiim represents 
some Arabic word meaning Engine, or Instrument 
(of Health) by which it is to be acquired or recovered, 
i. e. it appeals to sick people, while the other book. 
On the Preservation of Health, is intended for the 

' De Crisibiis : genuine. 

' De Dinariiidiis .- a spurious work. It is not known 
in Greek, and only exists in Latin, and was probably 
written about the end of the twelfth century. The 
name of the author is unknown. 

' Comment, in Aphorism, Hippocrat. ; Comment, in 
Prognost. Hippocrat. ; Comment, in Regiment Acu- 
toj'iun Hippocrat.'. all with text of Hippocrates are 

" De Simplici Medicina : genuine. The full title is 
De Simplicinm Medicamentornm temperamentis et 

' De Sinocho : I cannot find any work of Galen with 
a Greek title corresponding to this, so suppose it to 
be spurious. It might perhaps be an extract. 

' De Morbo et Accidenti : this is unknown in Greek, 
and is only found in Latin, apparently translated 
from the Arabic, and therefore not genuine. I 
strongly suspect that it is a compendium or abstract 
of several books about symptoms (accidens), such as 
De Symptomatum Causis, three books, and De Sym- 
ptomatum Differentiis ; also called De Morborum 
Causis and De Morborum Differentiis. But this is 
only a conjecture. 

' De Interioribus Membris : spurious ; also called 
A?tafomia Interiorum or Principaliufn Membrorum, 
a little Latin tract on anatomy, written probably in 


the twelfth century, and often ascribed to Magister 
Ricardus or Ricardus Anghcus. It was attributed 
to Galen because the preface or prologue begins, 
"Galienus testatur,"or"Galieno testante". The name 
of Galen coming first has caused it to be generally- 
catalogued under his name in European libraries, and 
the old British Museum Catalogues have it so. In 
other libraries, if it is desired to find a MS. of the 
work, search has first to be made under the name 

' De Mala Complexione : genuine ; I suppose the 
same as De inaequali tempore, or De inaeqtiali intem- 
pore, translated by Linacre. 

' Megrategni : genuine ; the same as Methodus 

' De JuvainentisMembroriifn: genuine ; the same 
as De Usu Parti2im. 

"■De Passio7iibus : I find no Greek title correspon- 
ding to this, so suppose it to be spurious. Whether 
it is the same as the Passionarhis called Galeiii, but 
really written by Gariopontus of Salerno, I cannot 

' Viaticum : certainly spurious. The Viaticum was 
given out by Constantine the African as his own. 
The editor of the printed edition says : " Quod Con- 
stantinus Africanus sibi arrogare non erubuit." It was 
also ascribed to Isaac Judaeus, but I think that, 
even now, the matter is not perfectly clear.' (J. F. P.) 
See below under Constantine and Gerard of Cremona. 

Serapion the elder. Works quoted : Practica ; 
De Aggregationibus ; ? De Proprietatibus Rerum. 
Number of times quoted, 22. 

Serapion, who lived in the ninth century, is other- 
wise known as John the son of Serapion. He was 
one of the physicians of the celebrated medical school 
at Gondisapor, a Nestorian establishment. The 
Practica, also called Breviariiim, was translated by 


Gerard of Cremona. Serapion the Younger lived 
about the end of the eleventh century, and wrote 
a treatise on drugs, which is possibly the De Pro- 
prietatibus Reruvi referred to, 

Gilbert the Englishman. Work quoted : 
Practica, Number of times, lo. 

Gilbertus Anglicus flourished at the end of the 
twelfth, and during the early part of the thirteenth, 
century. He was physician to Hubert Walter, 
Chancellor to Richard I and John, and probably 
took part in the Crusades. He is Chaucer's Gil- 
bertyne, who is mentioned in the Canterbury Tales 
together with Bernard of Gordon and Gaddesden. 
He studied and practised abroad, and thus got the 
cognomen Anglicus, which obviously he would not 
have acquired in his own country. He was a devoted 
scholar of the school of Salerno, and also well 
read in the Arabian writers. The Practica which 
Gaddesden quotes is the Compendium Mediciriae 
which was printed at L^'ons in 1510. 

Isaac Judaeus. Works quoted: De Febribus ; 
De Urinis. Number of times quoted, 25. 

Abu Ya'qub Ishaq ben Sulaiman al Israili (whose 
Jewish name is Isaac Israeli) was born in Egypt 
about the middle of the ninth century, and is said to 
have lived to the age of over a hundred. He was first 
in the service of the Aglabite Emir, Ziyadat Allah, 
and on the fall of that dynasty took service under 
the Fatimide al Mahdi, and apparently spent the 
rest of his days at Kairawan. He was the author 
of sundry medical works besides the two treatises 
on Urines and on Fevers. The Pantegni is probably 
attributed to him in error. 

Aegidius Corboliensis. Works quoted : De 
Pulsibus ; De Urinis. Number of times quoted, 8. 

Aegidius Corboliensis, or Gilles de Corbeil, was 
a celebrated physician of the twelfth century, and 


was in the service of Philip Augustus. He studied 
at Salerno, and has left various works in very fairly 
classical Latin verse Besides the De Ptclsibus et 
Urints he wrote a most amusing poem satirizing the 
clergy, entitled Hie^-apigra, and a poem on drugs, 
De Laudibus et Virtuiibiis compositor^im Medica- 
niinum. There is also a fragment in the Bodleian of 
a poem entitled De Sif^uis et Syjnptoniatibus Aegri- 
tudinum. The best account of him is to be found in 
M. C. Vieillard's Gilles de Corbeil, Paris, 1909. 

Confusionhas arisenbetween Aegidius Corboliensis 
and another Aegidius, or rather Joannes de Sancto 
Aegidio, otherwise John of St. Albans. And this all 
the more easily in that the latter was also a physician 
and in the service of Philip Augustus. Yet another 
Aegidius, namely Aegidius Romanus, flourished at the 
end of the thirteenth century, and is said to have 
been the author of a treatise De Formatione Corporis 
or De Formatione Fetus. Gaddesden quotes from 
it under the latter title with the name of the author 
as Aegidius on fol. 24. 

Hippocrates. Works quoted: Aphorisms. 
Number of times quoted, 120. 

Hippocrates was the great physician of antiquity. 
He was a native of Cos, and was born about B.C. 460. 
The Aphorisms from which Gaddesden quotes were 
those edited with a commentary by Galen, and they 
were translated into Latin at Monte Cassino by 
Constantine in the eleventh century. The translation 
from the Greek into Arabic was made by Hunain 
and Hubaish in the ninth century. The-most impor- 
tant work of Hippocrates was the treatise entitled 
Airs, Waters, and Places, which was also translated 
by Hunain. 

AvENZOAR. Gaddesden does not mention any 
work. Avenzoar is quoted three times, once 
directly and twice as quoted by Averroes in the 


Colliget. The place where he is mentioned directly 
is on fol. 136 verso, in the section on poisons : ' Item 
lapis smaragdinus inventus in capite buffonis viridis 
et splendidus, sic dicit Avenzoar, tritus datus cum 
aqua vel cum vino ad pondus granorum ix, educit 
venenum cum vomitu.' 

Avenzoar died in 1162; the date of his birth is 
unknown. His name in full was Abu Marwan 'Abd 
al-malik ben Abil-'ala ben Zuhr. Averroes, who 
was his pupil, says in the Colliget that he lived to the 
age of 135 and did not begin to study medicine until 
he was 40. He lived in Seville in the service of the 
Almoravide and Almohade dynasties. His chief 
work was the Taisir, which he dedicated to Aver- 
roes, but he also wrote a treatise on Diseases and 
Remedies of which a MS. exists at Paris. The 
Taisir was translated into Latin at Venice, and the 
prologue to the edition printed in 1490 runs as 
follows : 

' Incipit liber editus in Arabico a perfecto viro 
Abu Maruan Avenzohar, et translatus de hebraico in 
latinum Venetiis a magistro Paravicio physico ipso 
sibi vulgarizante magistro Jacobo hebreo. Anno 
Domini Jesu Christi MCCLXXX ; primo mense 
augusto die Jovis in meridie.' 

Colophon :—' Venetiis MCCCCLXXXX.' 
Damascenus. Works quoted : Aphorisms, With, the 
commentary of Isidore. Number of times quoted, 
53. He is also quoted without mention of Isidore 
three times. 

Joannes Damascenus, sometimes called Janus 
Damascenus, was given in the Middle Ages as the 
author of certain works translated from the Arabic. 
These works are now attributed either to Mesue the 
Elder, about the eighth century a.d., or to Serapion 
the Elder, about the ninth century a. d. 

The Aphorisms quoted by Gaddesden are to be 


found bound up in the collection entitled Articella, 
of which many editions were printed. In that 
printed at Lyons in 15 15 they are headed, 'J oh. 
Damasceni medici clarissimi Aphorismi.' The Latin 
translation was made by Gerard. Gaddesden almost 
always quotes from a commentary on the Aphorisms 
by Isidore, thus : ' Sic Isidorus super secunda 
particula affo. Dama. commento 60.' Who this 
Isidore was is unknown, and he and his commentary 
do not appear to be noticed elsewhere. 

RoGERius. No work mentioned. Number of 
times quoted, 6. 

Dr. Payne's note on this name says : — ' According 
to Pansier of Avignon, who has written on the school 
of Montpellier, the Rogerina (major and minor) was 
written by Rogier, Rogerius de Varone or Barone, a 
physician of Montpellier, who may have been 
Chancellor there. He was more "a medical than a 
surgical writer". He lived about the end of the 
thirteenth century and his work is also known as 
Su77tma Roger ii or Practica. On the other hand, 
Pagel strongly asserts the old view that the Rogerina 
means the surgery of the earliest Salernitan surgeon 
Rogerius, whose work was edited by Roland of 
Parma, and generally met with under the name 
Rolandina. Roger was born in the twelfth century, 
and there is nothing to connect him with Montpellier. 
I agree with Pansier and others ; I think the work 
quoted must be the chiefly medical work of Rogerius 
de Varone, and not the purely surgical Roger edited 
by Roland.' (J. F. P.) 

Theodoricus. Works mentioned : Major Chi- 
rurgia. Number of times quoted, 4. 

Theodoric was the pupil and son of Hugo of 
Lucca. He was also Bishop of Cervia and surgeon 
to Innocent IV. Guy de Chauliac unkindly says 
that he compiled his book by stealing everything 


from Bruno, and he certainly took his practice of 
dressing wounds with wine and dry dressings from 
that surgeon. He died in 1298. 

AvERROES. Works quoted : Colliget, i. e. Kitab 
al-Kulliyat, Generalities of Medicine ; Commentary 
on the Cantica of Avicenna. Number of times 
quoted, 98. 

Abul-walid Muhammad ben Ahmad ben Mu- 
hammad ibn Rushd, commonly known .as Averroes, 
whose name has come down to us rather as a 
philosopher than as a physician, was born at Cordova 
in A. D. 1 1 26. Besides being philosopher and 
physician, he was first Cadi of Seville and later 
Cadi of Cordova. He was accused of free- thinking 
opinions, and was exiled to Lucena near Cordova 
and his goods confiscated. He died in 11 98. 

The Colliget is a work in seven Books dealing 
with medicine in general. The Cantica of Avicenna, 
upon which Averroes wrote a commentary, is a 
poetical handbook of medicine in the metre called in 
Arabic, Arjuza. Both works were translated into 
Latin by Ermengardus of Montpellier about the 
middle of the thirteenth century. 

Mesue. Works quoted : Generally no name, 
sometimes Antidotarium. Number of times quoted, 


The Mesue (i. e. Ibn Masawaih) from whom 
Gaddesden quotes was probably the person known 
as Mesue the Younger, who is said on the authority 
of Leo Africanus to have lived in the eleventh century. 
Anyway, a work under his name was current in the 
Middle Ages, written in Latin, but no Arabic original 
exists. The work in quesl;ion is one on drugs, and is 
divided into four parts. The last part, De Aegritu- 
dinibus, deals with the medicines proper for each 
disease in particular. 

Rhazes. Works quoted : De DoloribiLS Jnnctu- 


rarum ; Aphorisms ; Almansor. Number of times 
quoted, 25, 

Abu Bakr Muhammad ben Zakariya, commonly 
called Rhazes, was born about the middle of the 
ninth century and died about the year a. d. 932. He 
studied at Baghdad, and his great work is called 
al-Hawi, in Latin Continejis. This was a complete 
treatise on the practice of medicine, and is specially 
valuable apart from its medical teaching in that it 
contains notices of celebrated men who had preceded 
him, Greek, Arab, and Persian. His other chief 
medical work was the Almansor, or, in Arabic, al- 
Mansu7'i, which w^as dedicated to al-Mansur, prince 
of Khorassan. He has also left a most important 
treatise upon small-pox and measles. In addition to 
these there are a number of treatises attributed to 
him under the name of Abubccri, which were 
translated into Latin by Gerard. Among these are 
the De Doloribus ytmcturarum, and the Aphorisms. 
Gerard also translated the Almansor, Book IX of 
which, De Aegritudinibus a capite usque ad pedes, was 
a favourite mediaeval textbook. 

JoANNiTius. Work quoted: Isagoge. Number of 
times quoted, 3. 

Joannitius, into which the name of Hunain ben 
Ishaq was latinized, was one of the great physitians 
and translators of the ninth century. He was born 
in the year a. d. 809 of a Christian Arab family at 
Hira. When a young man he went to Baghdad to ask 
Yahya ibn Masawaih, i. e. Mesue the Elder, to receive 
him as his pupil. The people of Hira had a reputa- 
tion for stupidity, ' passaient pour des Beotiens,' 
to use Leclerc's expression, and Mesue therefore 
repulsed Hunain. He accordingly went away and 
studied in Greece, and possibly in Alexandria, for 
two years. He then travelled in Persia, studied 
Arabic at Bassora, and returned to Baghdad. Here 

1308 M 


he commenced making translations from the Greek 
into Arabic of such excellence that they won the 
esteem of Gabriel, son of Bukht-yeshu', and of Mesne 
himself, who now received Hunain with open arms. 
Hunain, assisted by his nephew Hubaish, was a most 
voluminous translator. Together they translated 
most of Hippocrates and the sixteen books of Galen. 
to say nothing of various works of Plato and 
Aristotle. Hunain's introduction to the Microtcgni 
of Galen was translated into Latin, and was much 
used in the Middle Ages as a textbook under the 
title of Isagoge yoannitii in Aledicinam. The name 
of the translator is unknown, and in places the Latin 
is very obscure. 

Nicholas. Work quoted : Antidotarium, Num- 
ber of times quoted, 17. 

Nicholas Praepositus of Salerno, who lived 
about 1 1 50, wrote a collection of formulae for 
compound medicines, or A ntidotai'han, which became 
one of the chief mediaeval textbooks in the subject. 
It was immensely popular, and formed the founda- 
tion of various other books up to the end of the six- 
teenth century. Then it aided in the compilation of 
the new Pharmacopoeias and was superseded by them. 

Bernard of Gordon. No work mentioned. 
Number of times quoted, 3. 

Bernard of Gordon was a teacher at Montpellier. 
He began to teach there in a. d. 1285 and wrote his 
Lilinm Mcdicinae in 1305, It was often printed, an 
edition appearing at Frankfort so late as 161 7. 
Although he does not mention the name, this is the 
book to which Gaddesden refers. 

Gerard of Cremona. Work quoted : Viaticum, 
Number of times quoted, 5. 

Gerard of Cremona was born in 1 1 1 4 and died in 
1187. He worked at Toledo, where he produced 
translations of seventy-six works. Among the. 
medical authors whom he translated was Galen, with 


a commentary of Ibn Ridhwan, Isaac Judaeus, 
Rhazes, Serapion, and Avicenna. 

It is uncertain whether Gerard of Cremona was 
the author of the Viaticum, or rather of the commen- 
tary upon it. Littre, in the Histoire LitUraire de la 
France, says that Gerard of Berry was the author 
of the commentary. The Vialiami itself was put 
forth by Constantine (p. 168) as his own, but Leclerc 
says that it is really a translation of a treatise by Ibn 
al-Jazzar, who was born at Kairawan and died about 
A. D. 1009. It appears to have been a kind of medical 
handbook for travellers. The authorship was also 
ascribed to Isaac, and on fol. 35 rect., col. 2, 
Gaddesden says: ' Dicit Isaac secundo Viatici vel 
Constantinus quod si &c.' 

Gaddesden mentions or quotes from a number 
of other authors or treatises. Some are difficult 
or impossible to identify, and often he mentions 
no particular book. Of those who can be identified 
are the followino-: 

DioscoRiDES. He is supposed to have lived about 
the second century a.d., and wrote a book on 
medicinal herbs and other remedies. This was 
translated from the Greek into Arabic by Stephanus, 
son of Basilius, about the middle of the ninth 
century. Dioscorides was Greek, a native of 
Anazarba in Cilicia, and served as an army surgeon. 
A mediaeval Latin translation was attributed to 
Peter of Abano (Petrus Aponensis), but Dioscorides 
was not really well known until the revival of learning 
in the sixteenth century. It is not likely that Gad- 
desden knew the complete works of Dioscorides, but 
there were several books containing extracts early 
translated into Latin, and known to the Anglo- 
Saxons. Sometimes the author of these is called 
Pseudo-Dioscorides. The Arabs apparently did not 
have much to do with making Dioscorides known 
in Europe. 


RuFUS. Rufus of Ephesus probably lived about 
the beginning of the second century a. d. Gaddesden 
quotes him five times. He wrote a large number 
of medical treatises, very many of which were trans- 
lated into Arabic. Latin translations were also made 
at an early date. 

Albertus Magnus. Works quoted : De proprie- 
tate Reritm ; De Medicinis simplicibzts ; Lib. Methau- <lO 
rorum. Number of times quoted, 5. 

Albertus Magnus was born in 1193, studied at 
Padua, and entered the Dominican Order. In 1260 
he was made Bishop of Ratisbon. He possessed 
extensive chemical and mechanical knowledge, ex- 
tensive, that is, for his age, and was considered to be 
both sorcerer and magician. 

Cesarius. Only quoted once and no work men- 

Cesarius was born a.d. 330, and was physician to 
the Emperor Constantius who died in 361. 

Joannes de Sancto Amando. Work mentioned : 
Tacuinus. Number of times quoted, 2. 

Joannes de Sancto Amando was a Canon of 
Tournai, and lived in the thirteenth century. He 
wrote an exposition on xh^ Anfidofarium of Nicholas 
and also some Tables, i.e. Concordantiae. These 
tables were also called Taquinus, from a corruption 
of an Arabic word meaning ' Tables ' (see below 
under Tagnus). On fol. 80 recto, col. 2, appears 
' Dicit Joannes de sancto Amando ... in tranquillo 
suo '. This sentence should read ' in Tacuino 

Tagnus. This word seems to have been a puzzle 
to mediaeval scribes and printers. On fol. 35 rect, 
col 2, it appears as Daqn. ; on fol. loi rect., col. i, 
as Tagn.\ on fol. 148 rect., col. 2, as Tarqmi.', and 
on fol. 80 rect., col. 2, as Tranquillus, i.e. 'Joannes 
de Sancto Amando in tranquillo suo '. The word is 
really taquinus or tacuintis, and is a corruption of an 



Arabic word taqwim meaning 'table', not a board, 
but something in tabular form. 

The word occurs in the title of a book printed at 
Strasbourg in 1531. Tac2iini Sanitatis Elluchascm 
Elimithar viedici de Baldath. Elluchasem Elimithar 
was the Latin rendering of Abul-hasan al-Mukhtar 
ben al-Hasan ben 'Abdun ben Sadun ben Butlan, 
who was a Christian Arab living at Baghdad during 
the eleventh century, and his book was called 
Taqwim as-siliha. It was a treatise on hygiene in 
general. When it was translated into Latin is un- 
known. It is possible that Gaddesden may have been 
quoting from this book when he says ' secundum 
Tarqnu ' or ' dicit Daqn '. 

TiiEOPiiiLUS. Quoted once. 

This Theophilus is probably Theophilus Proto- 
spathariuswho held office under Heraclius. He wrote 
a treatise De Urinis, which is found in many editions 
of the Articella and is generally immediately pre- 
ceded or followed by another treatise by Philaretus, 
De Pulsibtcs. Gaddesden quotes this also. Philare- 
tus and Theophilus are presumably the same person. 

Urso. Urso was one of the Salernitan Masters 
and flourished about a.d. 1180. Gaddesden quotes 
him twice 'in affor. suis'. Urso was one of the 
teachers of Gilles de Corbeil, who speaks of him as 

* Strenuus ambiguos caussarum solvere nodos 
Cujus ab ingenio nulla indecisa recedit 
Ouaestio.' . . . 
{De niediumientis composiiis, i. 122.) 

Hugo de Lucca. Quoted once. 

Hugo de Lucca was the city surgeon of Bologna 
in A.D. 1 2 14. No writings of his have come down 
to us, but his methods of practice have been described 
by his son and pupil Theodoric, Bishop of Cervia, q.v. 

Lanfranc, Roland, Bruno. These three sur- 
geons are quoted in one place, fol. 157 verso, col. 2, 


as being old-fashioned and wrong in their surgery. 
Lanfranc was pupil of William de Saliceto and 
flourished at the end of the thirteenth century. He 
wrote a treatise on Surgery which was translated 
into English about 1380, and also about 1420. 
These two texts have been published by the E.E.T.S., 
Original Series 102, 1894. 

Roland is Roland of Parma. In 1264 he edited 
the Practica Chirurgiae of Roger, q. v. 

Bruno was a thirteenth-century surgeon who lived 
just previously to Theodoric. It was from him that 
Theodoric took the idea of dressing wounds with 
wine and dry dressings. 

Rabbi Moses. Quoted once. 

Rabbi Moses was the great Malmonides. His 
Arabic name was Abu 'Imran Musa ben Maimun, 
and he was born at Cordova in a.d. 1135. He 
was educated by his father ; although a Jew by 
birth, he is said to have conformed to the religion of 
Islam when about thirty years of age. His niedical 
writings include a commentary on the Aphorisms of 
Hippocrates, some Aphorisms of his own in twenty- 
five chapters, an abridgement of Galen, and the de 
Regimine Saniiatis} This was written to the order of 
the Sultan of Egypt, al-Malik al- Afdhal. The Latin 
translation was made by Ermengardus (Armengauld) 
of Montpellier. There is a MS. in the Bodleian. 
Several printed editions are known which bear the 
title, Rabbi Moysis Maimonidis, de Regimine Sani- 
iatis ; or Tractahts Rabbi Moysis quern Soldano 
Babiloniae transmisit. 

Haly Abbas. Works quoted: De Dispositione 
Regali. Quoted once. 

'Ali ibiraK Abbas, who died in a.d. 994, was 
generally called al-Majusi or the Magus, which 
seems to show that he was Persian in origin. H is 

1 This must not be confounded with the much better known 
Regimen Sanilaiis of Salerno. 


great work on medicine, the Maliki ox Royal Book, 
is an encyclopaedia of Medicine. Constantine the 
African translated most of it about 1080, and it was 
issued as by Haly, by Stephen of Antioch, in 11 27 
under the title of Regalis Dispositio. Printed editions 
appeared at Venice in 1492 and at Lyons in 1523. 
The Maliki enjoyed a great vogue until the appear- 
ance of the Canon of A vicenna, when it rapidly went 
out of fashion. So says Jamal-ad-din al-Oifti, who 
wrote a history of scientific men early in the thir- 
teenth century. 

Platearius. Works quoted : De Anrea ; Circa 
Instans. Number of times quoted, 2. 

Platearius was Matthew Platearius, a member of 
a distinguished medical family of Salerno, one of 
whom married Trotula. Matthew wrote a commen- 
tary upon the Aniidotarium of Nicolas, and also 
De Simplici Medicina Liber, which is generally 
quoted as Circa Instans. Gaddesden quotes it so on 
fol. 48. The opening words oi the book are ' Circa 
instans negotium'. 

Joannes. Quoted on fol. 6 rect, col. i, as being 
the inventor of a laxative powder made of agaric, 
turbith, rhubarb, and ginger. This Joannes may 
have been Pope John XXI, otherwise called Petrus 
Hispanus. He studied at Paris and Montpellier, and 
was physician to Gregory X. He wrote a Thesaurus 
Pauperum containing many prescriptions and recipes. 

Arnold de Villanova. Quoted once. 

Arnold was born in 1235 and died in 131 2. He 
led a strenuous and turbulent life. Hewas a Doctor 
in the three faculties of divinity, law, and physic. 
He wrote a commentary on the Regimen Sanitaiis 
of Salerno, and in addition (possibly) the Breviarium 
Medici nae. 

Alexander. Alexander Trallianus. There were 
early Latin translations of his works, well known to 
the Anglo-Saxons amongst others, and later. He is 


jTj-enerally called Alexander Yatros in the old books. 
The date of his birth was a. d. 525. 

RiCARDUS. Probably Magister Ricardus of Salerno, 
otherwise called Ricardus Anglicus. He wrote a 
work called Microloj^ics containing five short treatises 
entitled, Practica, De Urinis, Anafomia, Repressiva, 
Prognostica. He was a Master of Salerno about the 
end of the twelfth century. 

GuALTERius. Gualterius Agulinus, author of an 
extremely popular book on Urines, copied innumer- 
able times. It has been edited and published by 
A. J. Pfeffer, Berlin, 1891. 

Alphingui or Alphinqui. Quoted on fol. 125 
verso, col. i. 

Possibly this name is a corruption of Abenguefit 
or Akbenguefit, otherwise Eben Guefit or Ibn 
Wafid, who was born in Toledo in a. d. 998. He 
was the author of a work on drugs and medicines, 
which was translated into Latin by Gerard of 
Cremona under the title of De Virtutibiis medicina- 
r7im et ciboriim. 

Algraph(ir)us : Algaph(ic)us. Quoted on fol. 
27 rect., col. 2. 

Possibly Ahmad ben Muhammad al-Ghafiqi, an 
eminent physician at Cordova who died in a. d. 1 165. 

Alguasin. Quoted on fol. 48. Possibly Alguasir, 
author of a Liber de curat, lapidis. 

Anticlaudianus. Quoted on ff. 88-89. Not an 
author, but the name of a poem by Alanus de Insulis. 
The reference is Distinct. II, Cap. v. 

BuscoLiENSis. Quoted on f. 54. Unknown. 

Oxford : Horace Hart, M.A., Printer to the University